Relationship Between Bipedal Bioimpedance Analysis Data and Cardiac Performance in Patients on Maintenance Hemodialysis

Total body water (TBW) has recently been recognized as having independent prognostic value in hemodialysis patients because of its relationship with hypertension and cardiac morbidity. The aim of this study is to investigate associations between TBW changes measured by bipedal bioelectrical impedance analysis (BP-BIA), and morphologic and functional cardiac changes assessed by echocardiography in hemodialysis patients before and after the same dialysis session.

Twenty clinically stable adult hemodialysis patients (13 males, 7 females; mean age [years]: 60 ± 15.6) who had been on regular dialysis treatment for at least six months were included in the study. We used BP-BIA and the Watson equations for estimating TBW before and after dialysis sessions. Echocardiographic measurements were performed in pre- and post-dialysis periods.

After dialysis, significant decreases in TBW-BP-BIA, TBW-W and body weight were observed. LVIDD, LVEDV, LVESV, LAD, RAD, SV and CO measurements were markedly decreased after dialysis sessions. Ejection fraction and heart rate did not change significantly after hemodialysis. TBW-BP-BIA values showed no correlation with cardiac chamber diameters and functions in pre- and post-dialytic periods.

In hemodynamically stable patients having normal left ventricular functions, a reduction in TBW during dialysis causes a diminution in the diameter of cardiac chambers. BP-BIA, a simple method, can be used for TBW measurement. In addition, in this study, no correlation was observed between pre- and post-dialytic period cardiac chamber diameters and TBW-BP-BIA.