Use of Multifrequency Bioimpedance Analysis in Male Patients with Acute Kidney Injury Who Are Undergoing Continuous Veno-Venous Hemodiafiltration

<div><p>Introduction</p><p>Fluid overload is a well-known predictor of mortality in patients with acute kidney injury (AKI). Multifrequency bioimpedance analysis (MF-BIA) is a promising tool for quantifying volume status. However, few studies have analyzed the effect of MF-BIA-defined volume status on the mortality of critically ill patients with AKI. This retrospective medical research study aimed to investigate this issue.</p><p>Methods</p><p>We retrospectively reviewed the medical records of patients with AKI who underwent continuous veno-venous hemodiafiltration (CVVHDF) from Jan. 2013 to Feb. 2014. Female patients were excluded to control for sex-based differences. Volume status was measured using MF-BIA (Inbody S20, Seoul, Korea) at the time of CVVHDF initiation, and volume parameters were adjusted with height squared (H²). Binary logistic regression analyses were performed to test independent factors for prediction of in-hospital mortality.</p><p>Results</p><p>A total of 208 male patients were included in this study. The mean age was 65.19±12.90 years. During the mean ICU stay of 18.29±27.48 days, 40.4% of the patients died. The in-hospital mortality rate increased with increasing total body water (TBW)/H² quartile. In the multivariable analyses, increased TBW/H² (OR 1.312(1.009-1.705), p=0.043) and having lower serum albumin (OR 0.564(0.346-0.919, p=0.022) were independently associated with higher in-hospital mortality. When the intracellular water (ICW)/H² or extracellular water (ECW)/H² was adjusted instead of the TBW/H², only excess ICW/H² was independently associated with increased mortality (OR 1.561(1.012-2.408, p=0.044).</p><p>Conclusions</p><p>MF-BIA-defined excess TBW/H² and ICW/H² are independently associated with higher in-hospital mortality in male patients with AKI undergoing CVVHDF.</p>