OS 19-09 Bioelectrical impedance phase angle as intradialytic hypotension predictor

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Abstract

Objective:

Water balance and blood pressure (BP) alterations are strongly associated in haemodialysis (HD) patients. Aim of this study was to determine whether bioelectrical impedance analysis (BIA) parameters can be used as predictors of intradialytic hypotension (IDH).

Design and Method:

We conducted an observational study of chronic HD patients. BIA was measured before the HD procedure using InBody S10 (Biospace, Seoul, Korea) body composition analyzer. Intracellular water (ICW), extracellular water (ECW), total body water (TBW), ECW/TBW ratio and phase angle (PhA) were selected as markers of hydration state and thus possible predictors of IDH. Patients had their BP registered during the HD. NKF KDOQI guidelines were used to define the IDH group. These patients had SBP drop of ≥ 20 mmHg or MAP drop of 10 mmHg or more. The BIA parameters and other IDH predictors were entered into multivariate logistic regression analysis with forward model selection process.

Results:

99 patients were enrolled into the study. More than a half were male patients 51.5 % (n = 51), on dialysis for 4.5 [2.0–8.5] years with mean Charlson co-morbidity index of 5.76 ± 2.23. The rate of IDH was 40.4 % (n = 40). The mean values of the BIA parameters were as follows: ICW (23.11 ± 5.20), ECW (15.45 ± 3.474), TBW (38.56 ± 8.59), ECW/TBW ratio (0.40 ± 0.013) and PhA (4.49 ± 0.98). Multivariate analysis of IDH predictors revealed the lower PhA (OR = 1.70 CI95% 1.07–2.68 p = 0,024) and higher SBP prior the procedure (OR = 1.03 CI95% 1.01–1.05 p = 0,011) as the risk factors.

Conclusions:

In our study, we report that nearly half of HD patients experience IHD episode. We conclude that BIA PhA can be used to evaluate the risk of IHD, providing basis for HD adjustment.

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