Skip to main content
Erschienen in: International Urology and Nephrology 5/2013

01.10.2013 | Nephrology - Original Paper

Associations between bioelectrical impedance parameters and cardiovascular events in chronic dialysis patients

verfasst von: Aline de Araujo Antunes, Francieli Delatim Vannini, Liciana Vaz de Arruda Silveira, Pasqual Barretti, Luis Cuadrado Martin, Jacqueline Costa Teixeira Caramori

Erschienen in: International Urology and Nephrology | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Malnutrition and fluid overload contribute to the poor cardiovascular prognosis of dialysis patients. Since bioelectrical impedance analysis is an option for the evaluation of body composition and for the monitoring of hydration state, it may assist in the identification of subjects at high cardiovascular risk. The objective of this study was to evaluate the association between bioelectrical impedance parameters and cardiovascular events.

Methods

The association between bioelectrical impedance parameters and fatal and non-fatal cardiovascular outcome was evaluated in 145 dialysis patients.

Results

The mean age of the population studied was 54.9 ± 15.4 years, 49.7 % were males, and 35.9 % had diabetes. Forty (27.6 %) patients developed cardiovascular events during the 16 months (8; 32) of follow-up. Comparison of patients with and without cardiovascular events revealed higher extracellular mass/body cell mass (ECM/BCM) and extracellular water/total body water ratios and higher C-reactive protein levels in the former. Survival analysis showed that an ECM/BCM ratio >1.2 and a phase angle <6° were associated with poor cardiovascular prognosis. Among nondiabetic patients, these parameters and capacitance were independently associated with cardiovascular events, suggesting that poor nutritional status and fluid overload are associated with the occurrence of these events.

Conclusions

Phase angle, capacitance and ECM/BCM ratio are valuable parameters for the evaluation of cardiovascular prognosis, supporting the use of bioelectrical impedance for the clinical assessment of dialysis patients.
Literatur
3.
Zurück zum Zitat Stenvinkel P, Chung SH, Heimburger O, Lindholm B (2001) Malnutrition, inflammation, and atherosclerosis in peritoneal dialysis patients. Perit Dial Int 21(Suppl 3):S157–S162PubMed Stenvinkel P, Chung SH, Heimburger O, Lindholm B (2001) Malnutrition, inflammation, and atherosclerosis in peritoneal dialysis patients. Perit Dial Int 21(Suppl 3):S157–S162PubMed
4.
Zurück zum Zitat Beddhu S, Pappas LM, Ramkumar N, Samore MH (2004) Malnutrition and atherosclerosis in dialysis patients. J Am Soc Nephrol 15(3):733–742PubMedCrossRef Beddhu S, Pappas LM, Ramkumar N, Samore MH (2004) Malnutrition and atherosclerosis in dialysis patients. J Am Soc Nephrol 15(3):733–742PubMedCrossRef
5.
Zurück zum Zitat Fagugli RM, Pasini P, Quintaliani G, Pasticci F, Ciao G, Cicconi B, Ricciardi D, Santirosi PV, Buoncristiani E, Timio F, Valente F, Buoncristiani U (2003) Association between extracellular water, left ventricular mass and hypertension in haemodialysis patients. Nephrol Dial Transplant 18(11):2332–2338PubMedCrossRef Fagugli RM, Pasini P, Quintaliani G, Pasticci F, Ciao G, Cicconi B, Ricciardi D, Santirosi PV, Buoncristiani E, Timio F, Valente F, Buoncristiani U (2003) Association between extracellular water, left ventricular mass and hypertension in haemodialysis patients. Nephrol Dial Transplant 18(11):2332–2338PubMedCrossRef
6.
Zurück zum Zitat Bross R, Chandramohan G, Kovesdy CP, Oreopoulos A, Noori N, Golden S, Benner D, Kopple JD, Kalantar-Zadeh K (2010) Comparing body composition assessment tests in long-term hemodialysis patients. Am J Kidney Dis 55(5):885–896. doi:10.1053/j.ajkd.2009.12.031 PubMedCrossRef Bross R, Chandramohan G, Kovesdy CP, Oreopoulos A, Noori N, Golden S, Benner D, Kopple JD, Kalantar-Zadeh K (2010) Comparing body composition assessment tests in long-term hemodialysis patients. Am J Kidney Dis 55(5):885–896. doi:10.​1053/​j.​ajkd.​2009.​12.​031 PubMedCrossRef
8.
Zurück zum Zitat van de Pol AC, Frenken LA, Moret K, Baumgarten R, van der Sande FM, Beerenhout CM, Kooman JP, Leunissen KM (2007) An evaluation of blood volume changes during ultrafiltration pulses and natriuretic peptides in the assessment of dry weight in hemodialysis patients. Hemodial Int 11(1):51–61. doi:10.1111/j.1542-4758.2007.00154.x PubMedCrossRef van de Pol AC, Frenken LA, Moret K, Baumgarten R, van der Sande FM, Beerenhout CM, Kooman JP, Leunissen KM (2007) An evaluation of blood volume changes during ultrafiltration pulses and natriuretic peptides in the assessment of dry weight in hemodialysis patients. Hemodial Int 11(1):51–61. doi:10.​1111/​j.​1542-4758.​2007.​00154.​x PubMedCrossRef
9.
Zurück zum Zitat Mushnick R, Fein PA, Mittman N, Goel N, Chattopadhyay J, Avram MM (2003) Relationship of bioelectrical impedance parameters to nutrition and survival in peritoneal dialysis patients. Kidney Int Suppl 87:S53–S56PubMedCrossRef Mushnick R, Fein PA, Mittman N, Goel N, Chattopadhyay J, Avram MM (2003) Relationship of bioelectrical impedance parameters to nutrition and survival in peritoneal dialysis patients. Kidney Int Suppl 87:S53–S56PubMedCrossRef
10.
Zurück zum Zitat Maggiore Q, Nigrelli S, Ciccarelli C, Grimaldi C, Rossi GA, Michelassi C (1996) Nutritional and prognostic correlates of bioimpedance indexes in hemodialysis patients. Kidney Int 50(6):2103–2108PubMedCrossRef Maggiore Q, Nigrelli S, Ciccarelli C, Grimaldi C, Rossi GA, Michelassi C (1996) Nutritional and prognostic correlates of bioimpedance indexes in hemodialysis patients. Kidney Int 50(6):2103–2108PubMedCrossRef
13.
Zurück zum Zitat Avram MM, Fein PA, Borawski C, Chattopadhyay J, Matza B (2010) Extracellular mass/body cell mass ratio is an independent predictor of survival in peritoneal dialysis patients. Kidney Int Suppl 117:S37–S40. doi:10.1038/ki.2010.192 PubMedCrossRef Avram MM, Fein PA, Borawski C, Chattopadhyay J, Matza B (2010) Extracellular mass/body cell mass ratio is an independent predictor of survival in peritoneal dialysis patients. Kidney Int Suppl 117:S37–S40. doi:10.​1038/​ki.​2010.​192 PubMedCrossRef
14.
Zurück zum Zitat Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847PubMedCrossRef Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847PubMedCrossRef
16.
Zurück zum Zitat Kushner RF, Schoeller DA (1986) Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr 44(3):417–424PubMed Kushner RF, Schoeller DA (1986) Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr 44(3):417–424PubMed
17.
Zurück zum Zitat Cohn SH, Vaswani AN, Yasumura S, Yuen K, Ellis KJ (1985) Assessment of cellular mass and lean body mass by noninvasive nuclear techniques. J Lab Clin Med 105(3):305–311PubMed Cohn SH, Vaswani AN, Yasumura S, Yuen K, Ellis KJ (1985) Assessment of cellular mass and lean body mass by noninvasive nuclear techniques. J Lab Clin Med 105(3):305–311PubMed
20.
Zurück zum Zitat Yokoi K, Lukaski HC, Uthus EO, Nielsen FH (2001) Use of bioimpedance spectroscopy to estimate body water distribution in rats fed high dietary sulfur amino acids. J Nutrition 131(4):1302–1308 Yokoi K, Lukaski HC, Uthus EO, Nielsen FH (2001) Use of bioimpedance spectroscopy to estimate body water distribution in rats fed high dietary sulfur amino acids. J Nutrition 131(4):1302–1308
21.
Zurück zum Zitat Fein PA, Gundumalla G, Jorden A, Matza B, Chattopadhyay J, Avram MM (2002) Usefulness of bioelectrical impedance analysis in monitoring nutrition status and survival of peritoneal dialysis patients. Adv Perit Dial 18:195–199PubMed Fein PA, Gundumalla G, Jorden A, Matza B, Chattopadhyay J, Avram MM (2002) Usefulness of bioelectrical impedance analysis in monitoring nutrition status and survival of peritoneal dialysis patients. Adv Perit Dial 18:195–199PubMed
22.
Zurück zum Zitat Ho LC, Wang HH, Chiang CK, Hung KY, Wu KD (2010) Malnutrition-inflammation score independently determined cardiovascular and infection risk in peritoneal dialysis patients. Blood Purif 30(1):16–24. doi:10.1159/000316682 PubMedCrossRef Ho LC, Wang HH, Chiang CK, Hung KY, Wu KD (2010) Malnutrition-inflammation score independently determined cardiovascular and infection risk in peritoneal dialysis patients. Blood Purif 30(1):16–24. doi:10.​1159/​000316682 PubMedCrossRef
23.
Zurück zum Zitat Booth J, Pinney J, Davenport A (2010) N-terminal proBNP–marker of cardiac dysfunction, fluid overload, or malnutrition in hemodialysis patients? Clin J Am Soc Nephrol 5(6):1036–1040. doi:10.2215/CJN.09001209 PubMedCrossRef Booth J, Pinney J, Davenport A (2010) N-terminal proBNP–marker of cardiac dysfunction, fluid overload, or malnutrition in hemodialysis patients? Clin J Am Soc Nephrol 5(6):1036–1040. doi:10.​2215/​CJN.​09001209 PubMedCrossRef
24.
Zurück zum Zitat Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gomez JM, Heitmann BL, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, Schols AM, Pichard C (2004) Bioelectrical impedance analysis-part I: review of principles and methods. Clin Nutr 23(5):1226–1243. doi:10.1016/j.clnu.2004.06.004 PubMedCrossRef Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gomez JM, Heitmann BL, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, Schols AM, Pichard C (2004) Bioelectrical impedance analysis-part I: review of principles and methods. Clin Nutr 23(5):1226–1243. doi:10.​1016/​j.​clnu.​2004.​06.​004 PubMedCrossRef
25.
26.
Zurück zum Zitat Cheng LT, Tang W, Wang T (2005) Strong association between volume status and nutritional status in peritoneal dialysis patients. Am J Kidney Dis 45(5):891–902PubMedCrossRef Cheng LT, Tang W, Wang T (2005) Strong association between volume status and nutritional status in peritoneal dialysis patients. Am J Kidney Dis 45(5):891–902PubMedCrossRef
27.
Metadaten
Titel
Associations between bioelectrical impedance parameters and cardiovascular events in chronic dialysis patients
verfasst von
Aline de Araujo Antunes
Francieli Delatim Vannini
Liciana Vaz de Arruda Silveira
Pasqual Barretti
Luis Cuadrado Martin
Jacqueline Costa Teixeira Caramori
Publikationsdatum
01.10.2013
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 5/2013
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-012-0337-3

Weitere Artikel der Ausgabe 5/2013

International Urology and Nephrology 5/2013 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.