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Validating the use of bioimpedance spectroscopy for assessment of fluid status in children.

Journal article
Authors Indranil Dasgupta
David Keane
Elizabeth Lindley
Ihab Shaheen
Kay Tyerman
Franz Schaefer
Elke Wühl
Manfred J Müller
Anja Bosy-Westphal
Hans Fors
Jovanna Dahlgren
Paul Chamney
Peter Wabel
Ulrich Moissl
Published in Pediatric nephrology
Volume 33
Issue 9
Pages 1601–1607
ISSN 1432-198X
Publication year 2018
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 1601–1607
Language en
Keywords Fluid volume, Bioimpedance, Chronic kidney disease, Overhydration, Total body water, Children, Haemodialysis
Subject categories Pediatrics


Bioimpedance spectroscopy (BIS) with a whole-body model to distinguish excess fluid from major body tissue hydration can provide objective assessment of fluid status. BIS is integrated into the Body Composition Monitor (BCM) and is validated in adults, but not children. This study aimed to (1) assess agreement between BCM-measured total body water (TBW) and a gold standard technique in healthy children, (2) compare TBW_BCM with TBW from Urea Kinetic Modelling (UKM) in haemodialysis children and (3) investigate systematic deviation from zero in measured excess fluid in healthy children across paediatric age range.TBW_BCM and excess fluid was determined from standard wrist-to-ankle BCM measurement. TBW_D2O was determined from deuterium concentration decline in serial urine samples over 5 days in healthy children. UKM was used to measure body water in children receiving haemodialysis. Agreement between methods was analysed using paired t test and Bland-Altman method comparison.In 61 healthy children (6-14 years, 32 male), mean TBW_BCM and TBW_D2O were 21.1 ± 5.6 and 20.5 ± 5.8 L respectively. There was good agreement between TBW_BCM and TBW_D2O (R2 = 0.97). In six haemodialysis children (4-13 years, 4 male), 45 concomitant measurements over 8 months showed good TBW_BCM and TBW_UKM agreement (mean difference - 0.4 L, 2SD = ± 3.0 L). In 634 healthy children (2-17 years, 300 male), BCM-measured overhydration was - 0.1 ± 0.7 L (10-90th percentile - 0.8 to + 0.6 L). There was no correlation between age and OH (p = 0.28).These results suggest BCM can be used in children as young as 2 years to measure normally hydrated weight and assess fluid status.

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