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140 results on '"Moissl, Ulrich"'

1. Significance of Interdialytic Weight Gain versus Chronic Volume Overload: Consensus Opinion

Author

Hecking, Manfred, Karaboyas, Angelo, Antlanger, Marlies, Saran, Rajiv, Wizemann, Volker, Chazot, Charles, Rayner, Hugh, Hörl, Walter H, Pisoni, Ronald L, Robinson, Bruce M, Sunder-Plassmann, Gere, Moissl, Ulrich, Kotanko, Peter, Levin, Nathan W, Säemann, Marcus D, Kalantar-Zadeh, Kamyar, Port, Friedrich K, and Wabel, Peter

Subjects
Cardiovascular, Kidney Disease, Dielectric Spectroscopy, Diet, Sodium-Restricted, Humans, Kidney Failure, Chronic, Plasma Volume, Renal Dialysis, Sodium, Sodium, Dietary, Water-Electrolyte Imbalance, Weight Gain, Hemodialysis, Fluid/electrolytes, Epidemiology, Volume overload, Interdialytic weight gain, Outcomes, additional, Clinical Sciences, Urology & Nephrology
Abstract

Predialysis volume overload is the sum of interdialytic weight gain (IDWG) and residual postdialysis volume overload. It results mostly from failure to achieve an adequate volume status at the end of the dialysis session. Recent developments in bioimpedance spectroscopy and possibly relative plasma volume monitoring permit noninvasive volume status assessment in hemodialysis patients. A large proportion of patients have previously been shown to be chronically volume overloaded predialysis (defined as >15% above 'normal' extracellular fluid volume, equivalent to >2.5 liters on average), and to exhibit a more than twofold increased mortality risk. By contrast, the magnitude of the mortality risk associated with IDWG is much smaller and only evident with very large weight gains. Here we review the available evidence on volume overload and IDWG, and question the use of IDWG as an indicator of 'nonadherence' by describing its association with postdialysis volume depletion. We also demonstrate the relationship between IDWG, volume overload and predialysis serum sodium concentration, and comment on salt intake. Discriminating between volume overload and IDWG will likely lead to a more appropriate management of fluid withdrawal during dialysis. Consensually, the present authors agree that this discrimination should be among the primary goals for dialysis caretakers today. In consequence, we recommend objective measures of volume status beyond mere evaluations of IDWG.

Published
2013

7. Heart Rate Classification Using Support Vector Machines

Author

Vogt, Michael, Moissl, Ulrich, Schaab, Jochen, Bock, H. -H., editor, Gaul, W., editor, Vichi, M., editor, Arabie, Ph., editor, Baier, D., editor, Critchley, F., editor, Decker, R., editor, Diday, E., editor, Greenacre, M., editor, Lauro, C., editor, Meulman, J., editor, Monari, P., editor, Nishisato, S., editor, Ohsumi, N., editor, Opitz, O., editor, Ritter, G., editor, Schader, M., editor, Weihs, C., editor, Spiliopoulou, Myra, editor, Kruse, Rudolf, editor, Borgelt, Christian, editor, Nürnberger, Andreas, editor, and Gaul, Wolfgang, editor

Published
2006
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12. MO599COMPARISON OF TOTAL BODY WATER MEASURED BY BIOIMPEDANCE SPECTROSCOPY TO UREA DISTRIBUTION VOLUME ESTIMATED FROM UREA KINETIC MODELING IN HEMODIALYSIS PATIENTS

Author

Mermelstein, Ariella, primary, Moissl, Ulrich, additional, Canaud, Bernard, additional, Kooman, Jeroen, additional, Lasky, Rachel, additional, Rivera-Fuentes, Lemuel, additional, Thijssen, Stephan, additional, Kaysen, George, additional, Raimann, Jochen, additional, and Kotanko, Peter, additional

Published
2021
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13. Using Bioimpedance Spectroscopy to Assess Volume Status in Dialysis Patients: Results from a Randomized Controlled Trial

Author

van der Sande, Frank M., van de Wal-Visscher, Esther R., Stuard, Stefano, Moissl, Ulrich, Kooman, Jeroen P., Interne Geneeskunde, MUMC+: MA Nefrologie (9), RS: Carim - V02 Hypertension and target organ damage, MUMC+: MA Alg Interne Geneeskunde (9), MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), and RS: NUTRIM - R3 - Respiratory & Age-related Health

Subjects
HEMODIALYSIS, BODY-COMPOSITION, Bioimpedance, MORTALITY, RESIDUAL RENAL-FUNCTION, HYDRATION, End-stage kidney disease, OVERLOAD, BLOOD-PRESSURE, Hemodiafiltration, MULTIFREQUENCY BIOIMPEDANCE, End-stage renal disease, INTERDIALYTIC WEIGHT-GAIN, Self-reported sleep duration, GUIDED FLUID MANAGEMENT, VOLUME, Blood pressure, PERITONEAL-DIALYSIS PATIENTS, Dialysis, Volume control, BIOIMPEDANCE SPECTROSCOPY, Outcome
Abstract

The aim of the paper is to reflect on the current status of bioimpedance spectroscopy (BIS) in fluid management in dialysis patients. BIS identifies fluid overload (FO) as a virtual (overhydration) compartment, which is calculated from the difference between the measured extracellular volume and the predicted values based on a fixed hydration of lean and adipose tissue mass. FO is highly prevalent in both hemodialysis (HD) and peritoneal dialysis (PD) patients, while levels of FO are at a population level comparable between PD patients and HD patients when measured before the dialysis treatment. Even mild levels of FO are independently related to outcome in patients on HD, PD as well as in nondialysis patients with advanced chronic kidney disease. FO is not only related to left ventricular hypertrophy (LVH) but also forms part of a multidimensional spectrum with noncardiovascular risk factors such as malnutrition and inflammation. Even after multiple adjustments, FO remains an independent predictor of mortality. BIS-assisted adjustment of dry weight in HD patients has been shown to improve hypertension control and LVH and has resulted in a decline in intradialytic symptomatology. On the other hand, with increased fluid removal, target weight may not always be reached due to an increase in intradialytic symptomatology, and care should be applied in target weight adjustment in fluid overloaded patients with severe malnutrition and/or inflammation. Although a reduction in hospitalization rate was suggested, the effect of BIS-guided dry weight adjustment on mortality has not yet been shown, however, although available studies are underpowered. In PD patients, results have been more equivocal, which may be partly related to differences in treatment protocols or study populations. Future large-scale studies are needed to assess the full potential of BIS.

Published
2020

15. Prevalence of fluid overload in an urban US hemodialysis population: A cross‐sectional study.

Author

Moissl, Ulrich, Fuentes, Lemuel Rivera, Hakim, Mohamad I., Hassler, Manuel, Kothari, Dewangi A., Rosales, Laura, Zhu, Fansan, Raimann, Jochen G., Thijssen, Stephan, and Kotanko, Peter

Subjects
*HYPERVOLEMIA, *CROSS-sectional method, *HEMODIALYSIS, *BODY composition, *AFRICAN Americans, *HYPERTENSION
Abstract

Introduction: Inadequate fluid status remains a key driver of cardiovascular morbidity and mortality in chronic hemodialysis (HD) patients. Quantification of fluid overload (FO) using bioimpedance spectroscopy (BIS) has become standard in many countries. To date, no BIS device has been approved in the United States for fluid status assessment in kidney patients. Therefore, no previous quantification of fluid status in US kidney patients using BIS has been reported. Our aim was to conduct a cross‐sectional BIS‐based assessment of fluid status in an urban US HD population. Methods: We determined fluid status in chronic HD patients using whole body BIS (Body Composition Monitor, BCM). The BCM reports FO in liters; negative FO denotes fluid depletion. Measurements were performed before dialysis. Post‐HD FO was estimated by subtracting the intradialytic weight loss from the pre‐HD FO. Findings We studied 170 urban HD patients (age 61 ± 14 years, 60% male). Pre‐ and post‐HD FO (mean ± SD), were 2.2 ± 2.4 and −0.2 ± 2.7 L, respectively. Pre‐HD, 43% of patients were fluid overloaded, 53% normally hydrated, and 4% fluid depleted. Post‐HD, 12% were fluid overloaded, 55% normohydrated and 32% fluid depleted. Only 48% of fluid overloaded patients were hypertensive, while 38% were normotensive and 14% hypotensive. Fluid status did not differ significantly between African Americans (N = 90) and Caucasians (N = 61). Discussion While about half of the patients had normal fluid status pre‐HD, a considerable proportion of patients was either fluid overloaded or depleted, indicating the need for tools to objectively quantify fluid status. [ABSTRACT FROM AUTHOR]

Published
2022
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29. Greater fluid overload and lower interdialytic weight gain are independently associated with mortality in a large international hemodialysis population

Author

Hecking, Manfred, primary, Moissl, Ulrich, additional, Genser, Bernd, additional, Rayner, Hugh, additional, Dasgupta, Indranil, additional, Stuard, Stefano, additional, Stopper, Andrea, additional, Chazot, Charles, additional, Maddux, Franklin W, additional, Canaud, Bernard, additional, Port, Friedrich K, additional, Zoccali, Carmine, additional, and Wabel, Peter, additional

Published
2018
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30. Ultra-long–term human salt balance studies reveal interrelations between sodium, potassium, and chloride intake and excretion12

Author

Birukov, Anna, Rakova, Natalia, Lerchl, Kathrin, Engberink, Rik HG Olde, Johannes, Bernd, Wabel, Peter, Moissl, Ulrich, Rauh, Manfred, Luft, Friedrich C, and Titze, Jens

Subjects
Adult, Male, Electrolytes, Infradian Rhythm, Sodium, Potassium, Humans, Longitudinal Studies, Cardiovascular Disease Risk, Sodium Chloride, Dietary, Water-Electrolyte Balance, Aldosterone, Diet
Abstract

The intake of sodium, chloride, and potassium is considered important to healthy nutrition and cardiovascular disease risk. Estimating the intake of these electrolytes is difficult and usually predicated on urine collections, commonly for 24 h, which are considered the gold standard. We reported on data earlier for sodium but not for potassium or chloride.We were able to test the value of 24-h urine collections in a unique, ultra-long-term balance study conducted during a simulated trip to Mars.Four healthy men were observed while ingesting 12 g salt/d, 9 g salt/d, and 6 g salt/d, while their potassium intake was maintained at 4 g/d for 105 d. Six healthy men were studied while ingesting 12 g salt/d, 9 g salt/d, and 6 g salt/d, with a re-exposure of 12 g/d, while their potassium intake was maintained at 4 g/d for 205 d. Food intake and other constituents were recorded every day for each subject. All urine output was collected daily.Long-term urine recovery rates for all 3 electrolytes were very high. Rather than the expected constant daily excretion related to daily intake, we observed remarkable daily variation in excretion, with a 7-d infradian rhythm at a relatively constant intake. We monitored 24-h aldosterone excretion in these studies and found that aldosterone appeared to be the regulator for all 3 electrolytes. We report Bland-Altman analyses on the value of urine collections to estimate intake.A single 24-h urine collection cannot predict sodium, potassium, or chloride intake; thus, multiple collections are necessary. This information is important when assessing electrolyte intake in individuals.

Published
2016

34. Long-Term Space Flight Simulation Reveals Infradian Rhythmicity in Human Na+ Balance

Author

Rakova, Natalia, Jüttner, Kathrin, Dahlmann, Anke, Schröder, Agnes, Linz, Peter, Kopp, Christoph, Rauh, Manfred, Goller, Ulrike, Beck, Luis, Agureev, Alexander, Vassilieva, Galina, Lenkova, Liubov, Johannes, Bernd, Wabel, Peter, Moissl, Ulrich, Vienken, Jörg, Gerzer, Rupert, Eckardt, Kai-Uwe, Müller, Dominik N., Kirsch, Karl, Morukov, Boris, Luft, Friedrich C., and Titze, Jens

Published
2013
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48. Body fluid volume determination via body composition spectroscopy in health and disease

Author

Moissl, Ulrich M, primary, Wabel, Peter, additional, Chamney, Paul W, additional, Bosaeus, Ingvar, additional, Levin, Nathan W, additional, Bosy-Westphal, Anja, additional, Korth, Oliver, additional, Müller, Manfred J, additional, Ellegård, Lars, additional, Malmros, Vibeke, additional, Kaitwatcharachai, Charoen, additional, Kuhlmann, Martin K, additional, Zhu, Fansan, additional, and Fuller, Nigel J, additional

Published
2006
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