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Assessment of the Effects of the Changes at Dialysate Glucose and Sodium Content on the Hemodynamia by Bioimpedance Analysis

Öztürk S|Demirel R|Güven Taymez D|Aysuna N|Şakar Ş|Çakir H|Ömer B|Yildiz A
Poster presented at the 22nd National Congress of Nephrology, Hypertension, Dialysis and Transplantation in Antalya, Turkey on the 16th – 20th November 2005
OBJECTIVES: Assessment of the hemodynamic effects of the changes at the concentrations of dialysate glucose and sodium contents by bioimpedance analysis (BIA).
METHODS: The patients (group 1 – G1-17 patients) underwent hemodialysis with dialysate that include 200mg/dl glucose and 140 mmol/dl Na for 4.5 hours in the middle session of the week. At the beginning and at the end of the session; hematocrit, vital parameters (tension arterial, pulse), ultrafiltration volume, plasma osmolarity and plasma renin activity were recorded. And also multi-frequency bioelectric impedance analyses (Bodystat®QuadScan 4000) were performed for all of the patients at 5, 50, 100 and 200 kHz, including impedance index (Z200/Z5). In the second middle week session the same procedure was performed with same glucose but 135 mmol/dl Na including dialysate (group 2 – G2), and at the third week, again, the same procedure was done with dialysate which includes 140 mmol/dl Na but no glucose (group 3-G3).
RESULTS: The changes of the ratio of the intracellular volume to total body weight (ICW/TBW) at the beginning and the end of the session were same for all groups. However there were significant difference in the ratio of the changes for extracellular volume/total body weight (ECW/TBW) in G2 compared to G1 and G2 (p values are <0.001 and 0.007 respectively). Likewise, the same changes were observed in the changes of impedance indexes (p values for G1-G2: 0.08, G1-G3: 0.44 and G2-G3: 0.063). There was significant increase of hypotensive events in G2 compared to other groups (p=0.001).
CONCLUSIONS: There were rationale changes in impedance values according to the development of hypotensive events in hemodialysis population. BIA is a good modality for showing the changes in the body fluid volumes at the hemodialysis time. BIA can be used to estimate lean body weight in this population. There were no changes in the hemodynamic parameters related to glucose concentration in dialysate fluid.
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