Concordance between bio-impedance analysis and clinical score in fluid-status assessment of maintenance haemodialysis patients: A single centre experience  

作　　者：Kamiti Muchiri Joshua K Kayima Elijah N Ogola Seth McLigeyo Sally W Ndung’u Samuel K Kabinga 

机构地区：[1]Clinical Medicine and Therapeutics,University of Nairobi,Nairobi+254,Kenya [2]Department of Clinical Medicine and Therapeutics,University of Nairobi,Nairobi+254,Kenya [3]Department of Public Health,University of Nairobi,Nairobi+254,Kenya [4]East African Kidney Institute,University of Nairobi,Nairobi+254,Kenya

出　　处：《World Journal of Nephrology》2022年第4期127-138,共12页世界肾病学杂志（英文版）

摘　　要：BACKGROUND The burden of chronic kidney disease(CKD)is rising rapidly globally.Fluid overload(FO),an independent predictor of mortality in CKD,should be accurately assessed to guide estimation of the volume of fluid to be removed during haemodialysis(HD).Clinical score(CS)and bio-impedance analysis(BIA)have been utilized in assessment of FO and BIA has demonstrated reproducibility and accuracy in determination of fluid status in patients on HD.There is need to determine the performance of locally-developed CSs in fluid status assessment when evaluated against BIA.AIM To assess the hydration status of patients on maintenance HD using BIA and a CS,as well as to evaluate the performance of that CS against BIA in fluid status assessment.METHODS This was a single-centre,hospital-based cross-sectional study which recruited adult patients with CKD who were on maintenance HD at Kenyatta National Hospital.The patients were aged 18 years and above and had been on maintenance HD for at least 3 mo.Those with pacemakers,metallic implants,or bilateral limbs amputations were excluded.Data on the patients’clinical history,physical examination,and chest radiograph findings were collected.BIA was performed on each of the study participants using the Quantum®II bio-impedance analyser manufactured by RJL Systems together with the BC 4®software.In evaluating the performance of the CS,BIA was considered as the gold standard test.A 2-by-2 table of the participants’fluid status at each of the CS values obtained compared to their paired BIA results was constructed(either++,+-,--or-+for FO using the CS and BIA,respectively).The results from this 2-by-2 table were used to compute the sensitivity and specificity of the CS at the various reference points and subsequently plot a receiver operating characteristic(ROC)curve that was used to determine the best cut-off point.Those above and below the best CS cut-off point as determined by the ROC were classified as being positive and negative for FO,respectively.The proportions of participa

关 键 词：Bio-impedance analysis Clinical score Chronic kidney disease Maintenance haemodialysis Fluid overload CONCORDANCE 

分 类 号：R73[医药卫生—肿瘤]