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Matthew Tabinor, Emma Elphick, Michael Dudson, Chun Shing Kwok, Mark Lambie, Simon J Davies
Both overhydration and comorbidity predict mortality in end-stage kidney failure (ESKF) but it is not clear whether these are independent of one another. We undertook a systematic review of studies reporting outcomes in adult dialysis patients in which comorbidity and overhydration, quantified by whole body bioimpedance (BI), were reported. PubMed, EMBASE, PsychInfo and the Cochrane trial database were searched (1990-2017). Independent reviewers appraised studies including methodological quality (assessed using QUIPS)...
March 13, 2018: Scientific Reports
Douglas Lewis, Andrew Blow, Jonathan Tye, Tamara Hew-Butler
Exercise-associated hyponatraemia (EAH) always involves a component of overhydration relative to available exchangeable sodium stores. In the majority of cases, this is purely due to excessive consumption of fluids during exercise. In a lesser number of cases, it is apparent that excessive sodium loss through sweat may play a role by decreasing the amount of acutely available exchangeable sodium. Two cases demonstrating the latter, one in an individual with cystic fibrosis (CF) and another in an endurance athlete without CF, demonstrate how elevated dermal sweat losses may contribute to a relative dilutional EAH along a pathophysiological continuum...
March 9, 2018: BMJ Case Reports
Silke Haerteis, Anja Schork, Thomas Dörffel, Bernhard N Bohnert, Regina Nacken, Matthias Wörn, Mengyun Xiao, Daniel Essigke, Andrea Janessa, Alvin H Schmaier, Edward P Feener, Hans-Ulrich Häring, Marko Bertog, Christoph Korbmacher, Ferruh Artunc
AIM: Recent work has demonstrated that activation of the epithelial sodium channel (ENaC) by aberrantly filtered serine proteases causes sodium retention in nephrotic syndrome. The aim of this study was to elucidate a potential role of plasma kallikrein (PKLK) as a candidate serine protease in this context. METHODS: We analyzed PKLK in the urine of patients with chronic kidney disease (CKD, n=171) and investigated its ability to activate human ENaC expressed in Xenopus laevis oocytes...
February 28, 2018: Acta Physiologica
Ulrich Steinwandel, Nick Gibson, Mandy Towell, Richard Parsons, James Rippey, Johan Rosman
AIMS AND OBJECTIVES: Measuring the prevalence of symptomatic (S-IDH) and asymptomatic intradialytic hypotension (A-IDH) or post-dialysis overhydration in a satellite haemodialysis clinic in Western Australia. BACKGROUND: Intradialytic hypotension is one of the most common side-effects of haemodialysis caused by ultrafiltration provoking a temporary volume depletion. The prevalence of asymptomatic hypotension during dialysis has been rarely reported, but is considered to have the same negative consequences as symptomatic hypotension on various end organs like the brain and the gastro-intestinal tract...
February 15, 2018: Journal of Clinical Nursing
Kook-Hwan Oh, Seon Ha Baek, Kwon-Wook Joo, Dong Ki Kim, Yon-Su Kim, Sejoong Kim, Yun Kyu Oh, Byoung Geun Han, Jae Hyun Chang, Wookyung Chung, Ki Young Na
INTRODUCTION: In peritoneal dialysis (PD) patients, volume overload is related to cardiac dysfunction and mortality, while intravascular volume depletion is associated with a rapid decline in the residual renal function (RRF). This study sought to determine the clinical usefulness of bioimpedance spectroscopy (BIS)-guided fluid management for preserving RRF and cardiac function in PD patients. SUBJECTS AND METHODS: This is a multicenter, prospective, open-label study that was conducted over a 1-year period (NCT01887262)...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Robert C Oh, Bryan Malave, Justin D Chaltry
Exertional heat illness and exercise-associated hyponatremia continue to be a problem in military and recreational events. Symptoms of hyponatremia can be mistaken for heat exhaustion or heat stroke. We describe three cases of symptomatic hyponatremia initially contributed to heat illnesses. The first soldier was a 31-yr-old female who "took a knee" at mile 6 of a 12-mile foot march. She had a core temperature of 100.9°F, a serum sodium level of 129 mmol/L, and drank approximately 4.5 quarts of water in 2 h...
January 22, 2018: Military Medicine
Seun Deuk Hwang, Jin Ho Lee, Seoung Woo Lee, Joong Kyung Kim, Moon-Jae Kim, Joon Ho Song
Overhydration and sarcopenia, related to an individual's nutritional status, have been associated with increased cardiovascular mortality and poor prognosis in patients on hemodialysis. The purpose of this study was to investigate the prediction of overhydration and sarcopenia on mortality in patients on hemodialysis using a body composition monitor. We conducted a systematic review and meta-analysis using a random-effects model. We searched the Cochrane Central Register, OVID MEDLINE, EMBASE and PubMed databases for all studies published prior to December 9, 2016 and reviewed the reference lists of relevant reviews, registered trials and relevant conference proceedings...
November 2018: Renal Failure
Graham Scotland, Moira Cruickshank, Elisabet Jacobsen, David Cooper, Cynthia Fraser, Michal Shimonovich, Angharad Marks, Miriam Brazzelli
BACKGROUND: Chronic kidney disease (CKD) is a long-term condition requiring treatment such as conservative management, kidney transplantation or dialysis. To optimise the volume of fluid removed during dialysis (to avoid underhydration or overhydration), people are assigned a 'target weight', which is commonly assessed using clinical methods, such as weight gain between dialysis sessions, pre- and post-dialysis blood pressure and patient-reported symptoms. However, these methods are not precise, and measurement devices based on bioimpedance technology are increasingly used in dialysis centres...
January 2018: Health Technology Assessment: HTA
Xavier Torterüe, Laurène Dehoux, Marie-Alice Macher, Olivier Niel, Thérésa Kwon, Georges Deschênes, Julien Hogan
BACKGROUND: Evaluation of patient's dry weight remains challenging in chronic hemodialysis (HD) especially in children. Inferior Vena Cava (IVC) measurement was reported useful to assess fluid overload both in adults and children. METHODS: We performed a monocentric prospective study to evaluate the relation between predialytic IVC diameter measurements and hydration status evaluated by physicians and bioimpedance spectroscopy (BIS) and between IVC measurements and persistent hypertension...
December 28, 2017: BMC Nephrology
Si-Jia Zhou, Qing-Feng Han, Ai-Hua Zhang, Wen Tang, Ling-Hua Sun
BACKGROUND/AIMS: Protein energy wasting (PEW) is a common medical phenomenon that is observed in maintenance dialysis patients. PEW also increases morbidity and mortality of these patients. Its pathogenesis is unclear. We hypothesize that serum irisin levels and volume overload may induce PEW in peritoneal dialysis (PD) patients. The aim of this study is to measure serum irisin levels, evaluate volume status of PD patients, and study their correlations with PEW in PD patients. METHODS: This study is a cross-sectional study with 160 PD patients from the PD center of Peking University Third Hospital and 35 healthy control subjects...
December 14, 2017: Kidney & Blood Pressure Research
Caroline S Y Eng, Devina Bhowruth, Mark Mayes, Lynsey Stronach, Michelle Blaauw, Amy Barber, Lesley Rees, Rukshana C Shroff
Background: Fluid balance is pivotal in the management of children with chronic kidney disease (CKD) and on dialysis. Although many techniques are available to assess fluid status, there are only a few studies for children, of which none have been comparable against cardiovascular outcome measures. Methods: We performed a longitudinal study in 30 children with CKD5-5D and 13 age-matched healthy controls (71 measurements) to determine a correlation between optimal weight by bioimpedance spectroscopy (Wt-BIS) and clinical assessment (Wt-CA)...
November 9, 2017: Nephrology, Dialysis, Transplantation
Fansan Zhu, Peter Kotanko, Nathan W Levin
This paper describes a method to estimate interstitial fluid volume and peripheral blood volume (BVP) in hemodialysis (HD) patients using whole body (wBIS) and calf (cBIS) bioimpedance spectroscopy techniques. The aim of this study was to evaluate the usefulness of the technique. Thirty five HD patients were studied pre and post HD. Extracellular volume (ECV) and total body water (TBW) were measured using wBIS and cBIS. The calf resistances at 5 kHz (R5) and at 1000 kHz (R1000) respectively reflect ECV and TBW in the calf...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Luminita Voroneanu, Cristina Gavrilovici, Adrian Covic
Overhydration is a frequent complication in dialysis patients. It has been linked with hypertension, left ventricular hypertrophy, arterial stiffness, atherosclerosis uremic cardiomyopathy, and all-cause mortality or cardiovascular morbidity. In addition, predialysis underhydration is also associated with increased risk of death in ESRD patients. In this context, the optimal evaluation of hydration status is a must. However, this mission is not easy or accurate. In the last 10 years, several new methods have been tested in dialysis patients, particularly bioimpedance and lung ultrasonography...
January 2018: Seminars in Dialysis
Adrian Covic, Adi-Ionut Ciumanghel, Dimitrie Siriopol, Mehmet Kanbay, Raluca Dumea, Cristina Gavrilovici, Ionut Nistor
BACKGROUND: Volume overload is a common complication in patients with end-stage kidney disease who undergo maintenance dialysis therapy and associated with hypertension, left ventricular hypertrophy and mortality in this population. Although bioimpedance analysis (BIA), an objective method to assess overhydration, is associated with poor outcomes in observational studies, in randomized controlled trials (RCTs) the results were conflicting. We have examined the role of BIA for assessing the "dry weight" and fluid status in order to improve fluid overload in comparison with a control or clinical-based prescription in patients with ESKD receiving haemodialysis or peritoneal dialysis...
December 2017: International Urology and Nephrology
Eun Mi Yang, Eujin Park, Yo Han Ahn, Hyun Jin Choi, Hee Gyung Kang, Hae Il Cheong, Il Soo Ha
Adequate fluid management is an important therapeutic goal of dialysis. Recently, bioelectrical impedance methods have been used to determine body fluid status, but pediatric reports are rare. To determine the accuracy of bioelectrical impedance methods in the assessment of body fluid statusof children undergoing hemodialysis (HD), 12 children on HD were studied. A multi-frequency bioimpedance analysis device (Inbody S10) and bioimpedance spectroscopy device (BCM) were used to evaluate fluid status. Fluid removal during a HD session (assessed as body-weight change, ΔBWt) was compared with the difference in total body water determined by each device (measured fluid difference, ΔMF), which showed strong correlation using either method (Pearson's coefficient, r = 0...
November 2017: Journal of Korean Medical Science
Thomas Butler
Background: Severe cholera is a life-threatening illness of hypovolemic shock and metabolic acidosis due to rapid and profuse diarrheal fluid loss. Emergency life-saving therapy is i.v. saline, optionally supplemented with potassium and alkali to correct the fluid deficit, potassium losses and acidosis. After this initial rehydration, for the next 2 days ongoing stool losses are replaced with oral rehydration solution (ORS), which contains sodium chloride, potassium and alkali together with glucose or rice powder as a source of glucose to serve as a carrier for sodium...
May 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
Ante Mandic, Ivan Cavar, Ivana Skoro, Ivan Tomic, Kristina Ljubic, Slavica Coric, Ivanka Mikulic, Igor Azinovic, Danijel Pravdic
The volume state of dialysis patients is important in guiding the dialysis process. Volume overload in these patients is associated with inflammation. The objectives of the present study were to assess the body composition of patients on hemodialysis; to determine the concentrations of B-type natriuretic peptide (BNP) in plasma and evaluate the association of BNP concentrations with volume overload; to determine the concentrations of C-reactive protein (CRP), albumin and superoxide dismutase (SOD) activities as indicators of inflammatory or antioxidant processes...
December 2017: Therapeutic Apheresis and Dialysis
Jae-Seok Kim, Jae-Won Yang, Jin Sae Yoo, Seung Ok Choi, Byoung-Geun Han
BACKGROUND: Chronic fluid overload is common in patients with chronic kidney disease (CKD) and can with time lead to diastolic dysfunction and heart failure. We investigated whether markers of fluid status, such as NT-proBNP and bioimpedance spectroscopy (BIS), can predict echocardiographic findings of diastolic dysfunction in non-dialysis CKD5 patients. METHODS: BIS, echocardiography, and measurement of serum NT-proBNP were performed in patients with non-dialysis CKD stage 5 at a single study visit...
2017: PloS One
Martin D Hoffman, Eric D B Goulet, Ronald J Maughan
Hydration guidelines found in the scientific and popular literature typically advise that body mass losses beyond 2% should be avoided during exercise. In this work, we demonstrate that these guidelines are not applicable to prolonged exercise of several hours where body mass loss does not reflect an equivalent loss of body water due to the effects of body mass change from substrate use, release of water bound with muscle and liver glycogen, and production of water during substrate metabolism. These effects on the body mass loss required to maintain body water balance are shown for a 161-km mountain ultramarathon running competition participant utilizing published data for the total energy cost, exogenous energy consumption and percentage from each fuel source, average participant body mass, and the extent of soft tissue fluid accumulation during an ultramarathon...
September 11, 2017: Sports Medicine
Ianis Siriopol, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
INTRODUCTION: Fluid overload is one of the most important, yet modifiable, risk factors associated with worse outcomes in hemodialysis (HD) patients. However, its precise assessment in clinical practice is still under investigation. MATERIAL AND METHODS: This is an observational prospective study which included 285 stable patients with end-stage renal disease on standard thrice-weekly HD therapy. Overhydration was assessed by the combination of relative fluid overload (RFO), using bioimpedance spectroscopy, and N-terminal pro-B-type natriuretic peptide (NT-proBNP)...
August 2017: Archives of Medical Science: AMS
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