Abstract:
Chronic Kidney Disease (CKD), especially its end-stage (ESRD) requiring
renal replacement therapy, is associated with significant morbidity and mortality.
Two critical and interconnected management challenges in this population are the
accurate assessment of hydration status and nutritional status. Fluid overload (FO)
is a strong independent predictor of cardiovascular events and all-cause mortality in
dialysis patients. Conversely, underestimation of dry weight leads to intradialytic
complications. Clinical assessment of dry weight is often imprecise. Malnutrition
and protein-energy wasting (PEW) are equally prevalent and detrimental,
complicating the clinical picture. Traditional tools like clinical examination, body
mass index (BMI), and serum albumin have limitations in differentiating between
fat, muscle mass, and fluid compartments. Bioimpedance analysis (BIA) is a non
invasive, reproducible, and relatively inexpensive bedside technique that estimates
body composition by measuring the resistance and reactance of the body to a low
level alternating electrical current. It provides quantitative data on total body water
(TBW), extracellular water (ECW), intracellular water (ICW), and body cell mass
(BCM). This thesis explores the application and utility of various BIA
methodologies in the comprehensive management of patients with CKD.
