Bioimpedance analysis in patients with chronic kidney disease

In recent years the use of bioimpedance analysis (BIA) for assessment of fluid status as well as body composition as a mean to assess nutritional status in CKD has increased. The interest in the method is due to the associations between fluid overload and cardiovascular disease, and between fluid overload and malnutrition, both of which contribute to an increased risk of morbidity and mortality (Hur et al., 2013; Onofriescu et al., 2014). Moreover, BIA devices are suitable for clinical use, since they are portable, easy to use and, with a median to low price. However, the results can be difficult to interpret and integrate into routine clinical care, and although impedance measurements can contribute to an increased understanding of the patient's fluid balance, the results should be used with caution and in combination with other physiological parameters and clinical assessments (de Ruiter et al., 2020; Scotland et al., 2018). The aim of this editorial is to contribute to increased awareness of the benefits and limitations of using bioimpedance in patients with CKD with or without dialysis, and contribute to improving the measurement quality, facilitating interpretations, and highlighting possible sources of error