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논문분류	춘계학술대회 초록집
제목	Monitoring volume status using bioelectrical impedance analysis in chronic hemodialysis patients
저자	Jung-ho SHIN, So-hee JEONG, Jin ho HWANG, *Su hyun KIM
출판정보	2017; 2017(1):
키워드	fluid overload; bioelectrical impedance analysis; chronic hemodialysis; cardiovascular event; mortality
초록	Objectives : Fluid overload can be an independent risk factor of cardiovascular events and all-cause death in end-stage renal disease (ESRD) patients on chronic hemodialysis. We performed a retrospective study to investigate whether chronic overhydration assessed by bioelectrical impedance analysis (BIA) increases the rate of these complications. Methods : In ESRD patients on chronic hemodialysis, we identified the ratio of extracellular water to total body water (ECW/TBW) every 6 months using BIA. Patients were divided according to ECW/TBW. The uncontrolled group included patients with all ECW/TBW measurements ≥0.40; in contrast, the controlled group included those with any measured ECW/TBW <0.40. Results : A total of 142 patients (85 [59.9%] in the controlled group and 57 [40.1%] in the uncontrolled group) were followed for 29 (12, 42) months. The risk of cardiovascular events was higher in the uncontrolled group (HR 2.4, 95% CI 1.2-5.1; P = 0.020) than it was in the controlled group; however, this difference disappeared after adjusting for age, sex, and Charlson comorbidity index (P = 0.104). On the other hand, the patients in the uncontrolled group had a higher risk of all-cause death than did those in the controlled group; this finding was independent of age, sex, and Charlson comorbidity index (HR 4.7, 95% CI 1.4 - 16.1; P = 0.013). Conclusions : Monitoring hydration status using BIA may help to predict allcause death in chronic hemodialysis patients. Further controlled studies are needed to confirm that strict volume control could reduce the rates of cardiovascular events and mortality in this population.
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