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What Total Body Water Measurement Should Be Used for Prescribing the Dialysis Dose in Low-Flow Home Daily Dialysis?

Authors :
Gautier N
Sampol J
Zagdoun E
Duquennoy S
Dione DJP
Edet S
Lobbedez T
Ficheux M
Source :
Blood purification [Blood Purif] 2022; Vol. 51 (6), pp. 540-547. Date of Electronic Publication: 2021 Aug 17.
Publication Year :
2022

Abstract

Introduction: In low-flow home daily dialysis (HDD), the dialysis dose is evaluated from the total body water (TBW). TBW can be estimated by anthropometric methods or bioimpedance spectroscopy.<br />Methods: A multicentric cross-sectional study of patients in HDD for >3 months was conducted to assess the correlation and the difference between the anthropometric estimate of TBW (Watson-TBW) and the bioimpedance estimate (BIS-TBW) and to analyse the impact on the dialysate volume prescribed.<br />Results: Forty patients from 10 centres were included. The median BIS-TBW and Watson-TBW were 35.1 (29.1-41.4 L) and 36.9 (32-42.4 L), respectively. The 2 methods had a good correlation (r = 0.87, p < 0.05). However, Bland-Altman analysis showed an overestimation of TBW with Watson's formula, with a bias of 2.77 L. For 4, 5, or 6 sessions per week, the use of Watson-TBW increases the dialysate prescription per week by 100 L, 45 L, or 10 L, respectively, over our entire cohort. There is no increase in the volume of dialysate prescribed with the 7 sessions per week schedule.<br />Conclusion: BIS-TBW and Watson-TBW estimation have a good correlation; however, Watson's equation overestimates TBW. This overestimation is negligible for a prescription frequency of >5 sessions per week.<br /> (© 2021 S. Karger AG, Basel.)

Details

Language :
English
ISSN :
1421-9735
Volume :
51
Issue :
6
Database :
MEDLINE
Journal :
Blood purification
Publication Type :
Academic Journal
Accession number :
34404044
Full Text :
https://doi.org/10.1159/000517815