The Feasibility of Semi-Continuous and Multi-Frequency Thoracic Bioimpedance Measurements by a Wearable Device During Fluid Changes in Hemodialysis Patients

Overview

Journal Sensors (Basel)

Publisher MDPI

Specialty Biotechnology

Date 2024 Mar 28

PMID 38544153

Authors

Melanie K Schoutteten

Lucas Lindeboom

Helene De Canniere

Zoe Pieters

Liesbeth Bruckers

Astrid D H Brys

Patrick van der Heijden

Bart De Moor

Jacques Peeters

Chris Van Hoof

Willemijn Groenendaal

Jeroen P Kooman

Pieter M Vandervoort

Affiliations

Soon will be listed here.

Abstract

Repeated single-point measurements of thoracic bioimpedance at a single (low) frequency are strongly related to fluid changes during hemodialysis. Extension to semi-continuous measurements may provide longitudinal details in the time pattern of the bioimpedance signal, and multi-frequency measurements may add in-depth information on the distribution between intra- and extracellular fluid. This study aimed to investigate the feasibility of semi-continuous multi-frequency thoracic bioimpedance measurements by a wearable device in hemodialysis patients. Therefore, thoracic bioimpedance was recorded semi-continuously (i.e., every ten minutes) at nine frequencies (8-160 kHz) in 68 patients during two consecutive hemodialysis sessions, complemented by a single-point measurement at home in-between both sessions. On average, the resistance signals increased during both hemodialysis sessions and decreased during the interdialytic interval. The increase during dialysis was larger at 8 kHz (∆ 32.6 Ω during session 1 and ∆ 10 Ω during session 2), compared to 160 kHz (∆ 29.5 Ω during session 1 and ∆ 5.1 Ω during session 2). Whereas the resistance at 8 kHz showed a linear time pattern, the evolution of the resistance at 160 kHz was significantly different ( < 0.0001). Measuring bioimpedance semi-continuously and wth a multi-frequency current is a major step forward in the understanding of fluid dynamics in hemodialysis patients. This study paves the road towards remote fluid monitoring.

Citing Articles

Effect of body orientation and joint movement on local bioimpedance measurements.

Abie S, de Roman A, Hou J J Electr Bioimpedance. 2024; 15(1):137-144.

PMID: 39371331 PMC: 11452779. DOI: 10.2478/joeb-2024-0016.

References

Jaffrin M, Morel H . Body fluid volumes measurements by impedance: A review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods. Med Eng Phys. 2008; 30(10):1257-69. DOI: 10.1016/j.medengphy.2008.06.009. View

Matsushita K, Ballew S, Yee-Moon Wang A, Kalyesubula R, Schaeffner E, Agarwal R . Epidemiology and risk of cardiovascular disease in populations with chronic kidney disease. Nat Rev Nephrol. 2022; 18(11):696-707. DOI: 10.1038/s41581-022-00616-6. View

Patel R, Matthie J, Withers P, Peterson E, Zarowitz B . Estimation of total body and extracellular water using single- and multiple-frequency bioimpedance. Ann Pharmacother. 1994; 28(5):565-9. DOI: 10.1177/106002809402800501. View

Jain A, Lindsay R . Intra and extra cellular fluid shifts during the inter dialytic period in conventional and daily hemodialysis patients. ASAIO J. 2008; 54(1):100-3. DOI: 10.1097/MAT.0b013e318162c404. View

Wang T, Syu J, Chu H, Sung Y, Chou L, Escott E . Intelligent Bio-Impedance System for Personalized Continuous Blood Pressure Measurement. Biosensors (Basel). 2022; 12(3). PMC: 8946827. DOI: 10.3390/bios12030150. View

Raimann J, Zhu F, Wang J, Thijssen S, Kuhlmann M, Kotanko P . Comparison of fluid volume estimates in chronic hemodialysis patients by bioimpedance, direct isotopic, and dilution methods. Kidney Int. 2013; 85(4):898-908. DOI: 10.1038/ki.2013.358. View

Schoutteten M, Vranken J, Lee S, Smeets C, De Canniere H, Van Hoof C . Towards personalized fluid monitoring in haemodialysis patients: thoracic bioimpedance signal shows strong correlation with fluid changes, a cohort study. BMC Nephrol. 2020; 21(1):264. PMC: 7353684. DOI: 10.1186/s12882-020-01922-6. View

Booth J, Pinney J, Davenport A . Do changes in relative blood volume monitoring correlate to hemodialysis-associated hypotension?. Nephron Clin Pract. 2010; 117(3):c179-83. DOI: 10.1159/000320196. View

Saunders C . The use of transthoracic electrical bioimpedance in assessing thoracic fluid status in emergency department patients. Am J Emerg Med. 1988; 6(4):337-40. DOI: 10.1016/0735-6757(88)90151-9. View

10.

Agarwal R, Andersen M . Prognostic importance of clinic and home blood pressure recordings in patients with chronic kidney disease. Kidney Int. 2006; 69(2):406-11. DOI: 10.1038/sj.ki.5000081. View

11.

Sarkar S, Wystrychowski G, Zhu F, Usvyat L, Kotanko P, Levin N . Fluid dynamics during hemodialysis in relationship to sodium gradient between dialysate and plasma. ASAIO J. 2007; 53(3):339-42. DOI: 10.1097/MAT.0b013e318033cba7. View

12.

Dasselaar J, van der Sande F, Franssen C . Critical evaluation of blood volume measurements during hemodialysis. Blood Purif. 2012; 33(1-3):177-82. DOI: 10.1159/000334142. View

13.

Anand I, Doan A, Ma K, Toth J, Geyen K, Otterness S . Monitoring changes in fluid status with a wireless multisensor monitor: results from the Fluid Removal During Adherent Renal Monitoring (FARM) study. Congest Heart Fail. 2012; 18(1):32-6. DOI: 10.1111/j.1751-7133.2011.00271.x. View

14.

Kyle U, Bosaeus I, De Lorenzo A, Deurenberg P, Elia M, Gomez J . Bioelectrical impedance analysis--part I: review of principles and methods. Clin Nutr. 2004; 23(5):1226-43. DOI: 10.1016/j.clnu.2004.06.004. View

15.

Swatowski A, Wizemann V, Zaluska W, Ksizek A . Thoracic impedance measurements during orthostatic change test and during hemodialysis in hemodialyzed patients. ASAIO J. 2005; 50(6):581-5. DOI: 10.1097/01.mat.0000144588.73907.eb. View

16.

Jaffrin M, Fenech M, Tolani M . Continuous monitoring of plasma, interstitial, and intracellular fluid volumes in dialyzed patients by bioimpedance and hematocrit measurements. ASAIO J. 2002; 48(3):326-33. DOI: 10.1097/00002480-200205000-00021. View

17.

Ohashi Y, Tai R, Aoki T, Mizuiri S, Ogura T, Tanaka Y . The Associations of Malnutrition and Aging with Fluid Volume Imbalance between Intra- and Extracellular Water in Patients with Chronic Kidney Disease. J Nutr Health Aging. 2015; 19(10):986-93. DOI: 10.1007/s12603-015-0658-x. View

18.

Reddan D, Szczech L, Hasselblad V, Lowrie E, Lindsay R, Himmelfarb J . Intradialytic blood volume monitoring in ambulatory hemodialysis patients: a randomized trial. J Am Soc Nephrol. 2005; 16(7):2162-9. DOI: 10.1681/ASN.2004121053. View

19.

Shulman T, Heidenheim A, Kianfar C, Shulman S, Lindsay R . Preserving central blood volume: changes in body fluid compartments during hemodialysis. ASAIO J. 2001; 47(6):615-8. DOI: 10.1097/00002480-200111000-00009. View

20.

Kyle U, Bosaeus I, De Lorenzo A, Deurenberg P, Elia M, Gomez J . Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr. 2004; 23(6):1430-53. DOI: 10.1016/j.clnu.2004.09.012. View