Skip to main content

Research Repository

Advanced Search

The use of bioimpedance spectroscopy to guide fluid management in patients receiving dialysis

Tabinor, Matthew; Davies, Simon


Matthew Tabinor


To summarize the findings of recent trials and meta-analyses designed to determine whether bioimpedance spectroscopy adds value to the clinical assessment of fluid status in dialysis patients so as to achieve a normally hydrated weight and put these in a contemporary context.

Eight trials (published 2010-2018) and two meta-analyses (2017) are reviewed. Both haemodialysis and peritoneal dialysis modalities are represented. Despite considerable heterogeneity in intervention, all are open-label randomized comparisons of a bioimpedance intervention with normal clinical practice in which clinicians were blinded to bioimpedance data. In a total of 1443 patients studied, no significant differences in mortality, cardiovascular or adverse events between groups were observed. Bioimpedance use was associated with a reduction in overhydration, especially when residual kidney function was not present and a greater reduction in blood pressure. A modest correlation in the change in fluid status and fall in systolic blood pressure was seen compared to baseline. A more rapid fall in urine volume was seen in the two studies with the greatest change in fluid status, with significantly higher risk of anuria in one. How bioimpedance was integrated with the complex process of decision making by clinicians was variable and not always explained.

The usefulness of bioimpedance spectroscopy in guiding fluid management in dialysis patients is not yet clear. Bioimpedance can drive clinical decisions that lead to significant changes in fluid status but the best way to apply this in clinical practice requires further studies.

Journal Article Type Article
Acceptance Date Jul 30, 2018
Publication Date Nov 1, 2018
Journal Current Opinion in Nephrology and Hypertension
Print ISSN 1062-4821
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 27
Issue 6
Pages 406-412
Keywords fluid status, blood pressure, bioimpedance
Publisher URL