THE USE OF BODY COMPOSITION MONITOR-GUIDED ULTRAFILTRATION TO REDUCE INTRADIALYTIC ADVERSE EVENTS IN IRAQI HEMODIALYSIS PATIENTS

Jawad Fadhil Al Tu.’ma.*, Ali Jasim Al Saedi, Fadhil J. Al Tu.’ ma

ABSTRACT

Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) demand hemodialysis (HD), which is often complicated by intradialytic adverse events due to poor fluid management. Traditional clinical methods for determining dry weight are biased and unreliable which can increase risks like hypotension and cardiovascular strain. Objectives: In this randomized controlled trial, the efficacy of bioimpedance spectroscopy-guided ultrafiltration in reducing complications among Iraqi CKD patients. Materials and Methods: Eighty Iraqi HD patients (40 per group) over six months were evaluated. For the BCM group, a specialized device called the Fresenius Body Composition Monitor was used to measure hydration levels and adjust fluid removal. In contrast, the clinical group relied on standard assessments. Results: Results demonstrated significant reductions in overhydration (6.7 vs. 2.1 liters, p<0.001) and blood pressure (systolic: -11.0 vs. -5 mmHg; diastolic: -6.0 vs. -1 mmHg, p<0.001) in the BCM group. Intradialytic adverse events, including hypotension (3.4 vs. 6.7 events/patient), muscle cramps (3.4 vs. 8.9), dyspnea (1.9 vs. 5.3), and dizziness (3.6 vs. 6.5), were significantly lower in the BCM group (all p<0.001). These findings highlight bioimpedance spectroscopy-guided ultrafiltration superiority in enhancing hemodynamic stability and reducing treatment-related complications. Our study underscores the viability of BCM technology in developing countries like Iraq, where overcrowded dialysis units and limited access to advanced care amplify challenges. BCM technology provides a scalable solution to improve patient outcomes, reduce healthcare burdens, and potentially lower long-term cardiovascular risks. Conclusion: According to observed data, this study makes a strong case for adding BCM to standard dialysis care worldwide, especially in regions where healthcare resources are limited.

Keywords: Hemodialysis, Bioimpedance spectroscopy, Body composition monitor, Intradialytic hypotension, Fluid management.