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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2018  |  Volume : 29  |  Issue : 3  |  Page : 518-523
Improvement in dialysis-related adverse events with use of body composition monitoring


1 King Abdullah Hemodialysis Center, South Riyadh, Saudi Arabia
2 Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
3 Department of Medicine, King Abdulaziz Medical City; Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

Correspondence Address:
Dr. Syed Hammad Raza
King Abdullah Hemodialysis Center, Shubra District, South Riyadh, Riyadh 12799
Saudi Arabia
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DOI: 10.4103/1319-2442.235203

PMID: 29970726

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This study aims to utilize body composition monitor (BCM) device to achieve euvolemic status in problematic dialysis patients and to evaluate its clinical outcome. One hundred and five hemodialysis (HD) patients were enrolled based on difficulty in achieving dry weight. The reasons for enrollment in the study were (a) recurrent intradialytic hypotension, (b) intradialytic hypertension, (c) intradialytic muscle cramps, or (d) the presence of comorbid conditions that make clinical assessment of dry weight difficult (e.g., cirrhosis of liver, heart failure, severe malnutrition, or morbid obesity). Following initial assessment of hydration status using BCM device, dry weight for each patient was adjusted accordingly (upward, downward, or unchanged). The patients were, thereafter, monitored over a 15-week period for possible resultant change in the clinical and hemodynamic parameters. Forty-two patients were monitored due to hypertension, 18 due to hypotension, 10 due to hypotension and cramps, and 35 due to comorbid conditions that make clinical assessment of dry weight difficult. At the conclusion of study period, there was improvement in the monitored parameters. Hypertension improved in 79% of the patient with hypertension, hypotension in 90%, and hypotension with cramps in 90%. In the comorbid group, BCM monitoring provided better insight to clinical problem management in 80% cases. Overall quality of BCM assessments was 96.1%. In the hypertension group, mean blood pressure decreased by 10.9 mm Hg in the whole group (P = 0.0006), the drop was 3 mm Hg in the patients dialyzing with HD (P = 0.0006) and 8.6 mm Hg in those on hemodiafiltration (HDF) (P = 0.08). In the comorbid conditions group, the mean blood pressure rose by 22.5 mm Hg in the whole group (P 0.00001), 21.5 mm Hg in the patients dialyzing with HD (P = 0.00001) and 21.5 mm Hg in those on HDF (P = 0.0004). BCM monitoring together with clinical assessment is a useful tool which when appropriately applied reduces the incidence of dialysis-related complications.


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