Abstract
A new concept of estimation of dry weight (DW) for hemodialysis (HD) patients is proposed. DW is defined as the state of body hydration in which refilling rate from arm and leg tends to dissociate from that from the trunk at the end of HD. The study investigated the relative value of measurement of changes in extracellular fluid volume (ECV), relative blood volume (RBV) and systolic blood pressure (SBP) in assessment of dry weight. Eleven patients were studied during regular 22 HD sessions. ECV regional refilling was measured by segmental bioimpedance analysis (SBIA). RBV and SBP were measured at 10min, intervals. Patients were divided into two groups according to the presence of hypotension at the end of HD. (Grl n= 6, pts with hypotension; Gr2 n=16, pts without hypotension). Difference between estimated DW and post-HD (ΔW) and the changes between the final and immediately previous measurement are indicated as ΔSBP, ΔRBV, ΔECVArm, ΔECVTrunk and ΔECVLeg respectively.TableThe results indicate that ΔSBP was significantly greater and Δ ECVArm, and ΔECVLeg were significantly less in group 1 patients. This limitation of refilling from the periphery to the trunk in group1 patients may indicate when dry weight is approached. Development of the SBIA technique could provide a new approach to the determination of dry weight in dialysis patients.
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