Impact of fluid overload on anaemia - presented at the WCN 2013

 
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Volume management was a key focus of Fresenius Medical Care during this year’s WCN – with the influence of fluid overload on anaemia being highlighted.

The World Congress of Nephrology (WCN) 2013 was held in Hong Kong from May 31–June 4 2013. Fresenius Medical Care actively participated in the scientific program presenting over forty abstracts that focused on optimising patient outcomes in dialysis. Two of these abstracts evaluated the consequences of fluid overload on anemia in haemodialysis (HD) patients.

Impact of fluid overload on anaemia, inflammatory status and hospitalisation1

Jirka and colleagues assessed the impact of fluid overload on anaemia, hospitalisation and inflammatory status in patients who had been on dialysis in Fresenius Medical Care (NephroCare) dialysis centres in the Czech Republic for more than 90 days and had a native fistula (n=864).1 Patients were divided into fluid overloaded and normo-hydrated groups using a cut off of fluid overload/extracellular water = 15%. Results showed that, compared with patients who were fluid overloaded, the normo-hydrated patient group had:1

  • Significantly higher levels of haemoglobin and albumin
  • Significantly lower EPO resistance index, C-reative protein (CRP) levels and hospitalisations

The authors concluded that this preliminary analysis highlights that objective monitoring of fluid overload can be used to identify those patients at higher risk.1

Fluid overload dilutes haemoglobin levels in CKD-3 and CKD-4 patients2

A poster presented at WCN 2013 by Moissl and colleagues assessed the degree of haemoglobin dilution in CKD (Chronic Kidney Disease) patients, and evaluated whether this has the potential to affect anaemia management.2 Fluid overload was measured in 497 patients with stage 3 (n=443) or 4 (n=54) CKD using Fresenius Medical Care’s Body Composition Monitor (BCM). As shown in Figure 1, results demonstrated that fluid overload was significantly correlated with decreasing haemoglobin levels.2

Figure 1. Fluid overload dilutes haemoglobin levels in CKD 3 and 4 patients2

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CKD 3: R=-0.32, p<0.001; CKD 4: R=-0.65, p<0.001.

The authors concluded that fluid overload significantly affects haemoglobin levels in CKD-3 and CKD-4 patients and should therefore be taken into account when assessing haemoglobin for anaemia management in those pre-dialysis patients.2

Fresenius Medical Care’s Body Composition Monitor (BCM) is the only device that has been validated for fast, accurate and non-invasive fluid status monitoring in both healthy subjects and dialysis patients.3,4 BCM is being used as part of a Fluid Management Program that is currently being rolled out across the Fresenius Medical Care (NephroCare) dialysis network, which comprises over 600 clinics across the globe. This involves objectively measuring the fluid status of more than 25,000 patients every month with BCM.1

For more information about how BCM might be useful in your clinic, please click here.

If you are interested in a trial of BCM in your clinic, please contact Fresenius Medical Care

References:

  1. Jirka T, Wabel P, Chamney P et al. Impact of fluid overload on anemia, inflammatory status and hospitalisation. Presented at the: World Congress of Nephrology (WCN). Hong Kong, May 31–June 4 2013: Abstract SU543.
  2. Moissl U, Wabel P, Wieskotten S et al. Fluid overload dilutes Hb levels in CKD 3 and 4 patients. Presented at the: World Congress of Nephrology (WCN). Hong Kong, May 31–June 4 2013: Abstract SU448.
  3. Moissl U, Wabel P, Chamney PW et al. Body fluid volume determination via body composition spectroscopy in health and disease. Physiol Meas 2006;27:921–33
  4. Chamney PW, Wabel P Moissl U et al. A whole-body model to distinguish excess fluid from the hydration of major body tissues. Am J Clin Nutr 2007;85:80–9.