The effect of changes in intra-compartmental bioimpedance measurements with early intra-dialytic hypotension during haemodialysis

Abstract

Introduction: Intra-dialytic hypotension (IDH) remains the commonest problem associated with routine haemodialysis treatments. Fluid shifts from intracellular(ICW) and extracellular(ECW) compartments to refill plasma volume during haemodialysis with ultrafiltration. Methods: We studied the effect of relative changes in ICW and ECW indifferent body segments using multifrequency segmental bioimpedance during haemodialysis and IDH episodes. Results: Of 42 haemodialysis patients,16 patients (38.1%) developed IDH within the first hour of dialysis. Patients with and without early IDH were well-matched for demographics and starting bioimpedance measurements. However, after 60 min, the relative change in in ECW/ICW ratio between the non-fistula arm and leg was significantly different for the early IDH group median −1.07 (−3.33 to 0.8) versus 0.61 (−0.78 to 1.8), p < 0.05, whereas there no differences in ultrafiltration rate, relative blood volume monitoring or on-line clearance. Conclusion: Monitoring serial changes in fluid status in different body compartments with bioimpedance may potentially prevent IDH in the future.