• Li Liu, Fansan Zhu, Jochen G Raimann, Stephan Thijssen, Murat H Sipahioglu, Gregory Wystrychowski, Thomas Kitzler, Ciro Tetta, Peter Wabel, Peter Kotanko, and Nathan W Levin.
• Renal Research Institute, Beth Israel Medical Center, New York, USA.
• Nephrology (Carlton). 2012 Feb 1;17(2):131-40.

AimThe aim of this study was to demonstrate the ability of widely used bioimpedance techniques to assess dry weight (DW) and to predict a state of normal hydration in haemodialysis patients whose post-dialysis weight had been gradually reduced from baseline in successive treatments over time.MethodsCalf bioimpedance spectroscopy (cBIS) was employed to determine DW (DW(cBIS) ) as defined by flattening of an intradialytic continuously measured resistance curve and by normalized resistivity (nRho) being in the gender-specific normal range. The wECV/TBW ratio was determined by 'classical' wrist-to-ankle whole body bioimpedance spectroscopy (wBIS); in addition, a novel whole body model (WBM) based on wBIS was used to predict normal hydration weight (NHW(WBM) ).ResultsTwenty-one haemodialysis patients were studied; 11 ± 6 measurements were performed per patient. Nine patients reached DW(cBIS) (DW(cBIS) group), while 12 patients remained fluid-overloaded (non-DW(cBIS) group). Change in wECV as measured by wBIS accounted for 46 ± 23% in DW(cBIS) group, which was higher than in non-DW(cBIS) group (33 ± 48%, P < 0.05) of actual weight loss at the end of study. In both groups the wECV/TBW ratio did not change significantly between baseline and study end. Mean predicted NHW(WBM) at baseline was 3.55 ± 1.6 kg higher than DW(cBIS) . The difference in DW(cBIS) and NHW(WBM) was 1.97 ± 1.0 kg at study end.ConclusionWBM could be useful to predict a target range of normal hydration weight particularly for patients with substantial fluid overload. The cBIS provides an accurate reference for the estimation of DW so that combined use of cBIS and WBM is promising and warrants further studies.© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.

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