[Whole body versus segmental bioimpedance measurements (BIS) of electrical resistance (Re) and extracellular volume (ECV) for assessment of dry weight in end-stage renal patients treated by hemodialysis].

The precise estimation of the hydration status of the human body has a great meaning in the assessment of dry weight in end-stage renal disease patients treated by hemodialysis. The bioimpedance technique (BIS) is postulated as easy in use and as a non-invasive method in monitoring the size of hydrate space such as total body water (TBW) and extracellular volume (ECV). However, the precision of the method (Whole Body Bioimpedance Technique) has been questioned in several research papers. One of the problems lies in fluid transfer from peripheral spaces (limbs) to the central space (trunk) while changing the position of the body (orthostatic effect). This phenomena can be eliminated using segmental bioimpedance technique (4200 Hydra, Analyzer, Xitron, San Diego, CA, U.S.A.). The purpose of the study was to estimate the changes of electrical resistance (Re) the extracellular volume (ECV) at the time -pre, and -post 10 hemodialysis sessions using whole body bioimpedance technique (WBIS) in comparison to BIS measurements in specific segments of the body; arm (ECVarm), leg (ECVleg), trunk (ECVtrunk). The sum of changes in extracellular volume (ECV) in segments (2ECVarm+ ECVtrunk + 2ECVleg) was 13.26 +/- 1.861 L in comparison to 17.29 +/- 2.07 L (p < 0.01) as measured by WBIS technique at the time before HD. The changes in electrical resistance Re was of 558 +/- 68 W as calculated from the sum of segments versus 560 +/- 70 W (p < 0.05) as measured by WBIS. At the time after hemodialysis the sum of segmental ECV volume measurement was of 11.42 +/- 1.28 L in comparison to 14.84 +/- 1.31 (p < 0.001) from WBIS the whole body technique (WBIS) and changes in electrical resistance Re was of 674 +/- 67 W as calculated from the sum of segments versus 677 +/- 64 (p < 0.05) W respectively. The observed difference between the identical electrical resistance Re as measured by WBIS in comparison to the sum of segment measurements and important difference between ECV volume as measured by WBIS versus sum of segment ECV measurements can be partly explain by non-cylindric nature of human body composition. However, the segmental bio-impedance technique is a method which gives us more accurate data about the extracellular volume taken from each segment in the hemodialysis patient but the accuracy of trunk water assessment is still a problem.