Bio-Impedance-Guided Target Weight Correction Improves Fluid Overload in Hemodialysis Patients: A Feasibility Study
Bibliographic record
Abstract
Background: Fluid overload in hemodialysis (HD) patients is highly prevalent and is associated with adverse cardiovascular outcomes. The hypothesis of this study was to implement a target weight correction protocol overseen by nursing staff in a hemodialysis unit to reduce fluid overload. This was successfully tested in a feasibility study. Arterial stiffness was measured in response to the intervention. Methods: Of the 16 patients included in the study, 10 were subjected to the intervention (in center 1) and 6 served as time controls (in center 2). Time-average fluid overload (TAFO = pre-dialysis fluid overload - ½ of the one-week averaged interdialytic weight gain) was used as fluid overload parameter. Fluid status was assessed at baseline and then monthly for 2 months before the start of mid-week dialysis run using multifrequency bioimpedance (Body Composition Monitor, BCM, Fresenius Medical Care) and arterial stiffness using (Arteriograph24TM, Budapest, Hungary). In the intervention group, target weight was adjusted every two weeks based on the BCM measurements. No adjustment of target weight was performed in the control group and the treatment team was blinded from the results. Results: At baseline, groups were comparable. After two months, TAFO had significantly decreased in the intervention group by 40% from 2.8±1.2 to 1.6±1.2 L (P <0.012), no change was seen in the control group (2.9±1.4 to 2.5±2.0 L, NS). With that, traditional pre-dialysis fluid overload decreased from 3.8±1.2 to 2.7±1.2 L (P <0.009) in the intervention group and no change was observed in the control group (3.6±1.3 to 3.6±2.2L, NS). Blood pressure after two months did not significantly differ in both groups (P>0.05). Arterial stiffness (PWV and AiX) remained unchanged in both groups. Conclusions: This feasibility study clearly demonstrates that fluid management using a target weight correction protocol based on TAFO assessed by BCM measurements can improve fluid status in HD patients. It did not coincide in this short study with changes in arterial stiffness.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".