Research - Dialysis Nephrology

The study aimed to assess the body composition changes after dialysis in chronic kidney disease (CKD) patients undergoing hemodialysis and to determine the strengths of relationships between various body composition parameters and blood lipid levels in these patients.

Most patients on peritoneal dialysis (PD) consume a normal Western diet that contains a large amount of salt. This causes increase in extracellular volume ("fluid overload") that has to be removed mostly with the dialysis fluid, as residual renal function (if present) cannot cope with it. In the present study, we prospectively investigated whether an increased extracellular volume (corrected for height) predicted technique survival in PD patients.

The aim of this study is to determine the prevalence and prognostic value of elevated cardiac troponin (cTnT) and its association with clinical characteristics according to renal function status in patients with stable heart failure.

The goal of this study was to compare the adequacy of single and multifrequency bioimpedance analysis (BIA) to evaluate body water compartments, body composition, and nutritional status in maintenance hemodialysis patients.

This thesis is based on clinical studies including virtually all patients treated with peritoneal dialysis in Gothenburg during the 1990s. The patients had a fundamentally altered body composition compared to healthy subjects, characterised by a reduction in body cell mass and body fat already at start of dialysis.

It is unclear whether the fluid status, as determined by bioimpedance vector analysis (BIVA) combined with serum N-terminal pro-B-type natriuretic peptides (NT-pro-BNP) measurement, is associated with treatment outcome among patients receiving continuous renal replacement therapy (CRRT). Our objective was to answer this question.

Bioimpedance vector analysis (BIVA) is valid for body composition analysis both in healthy and pathological population. It is a useful method to evaluate tissue hydration. BIVA is particularly suited to follow hydration states in haemodialysis, to analyse emergency and ICU conditions, as well as optimize nutritional or physical activity programs.

Atherosclerosis and inflammation have been implicated in the alteration of pulsatile characteristics of blood vessels. Analysis of the arterial waveform can be resolved into an index of elasticity for both large (LAEI) and small (SAEI) arteries. SAEI is a novel marker of endothelial function and reduced SAEI is prognostic for cardiac events. Phase angle derived from bioimpedance analysis (BIA) is presumed to indicate cell membrane health and decreased phase angle correlates with increased mortality in PD patients. We evaluated 18 stable, established PD patients with both BIA (Quadscan 4000, BodyStat) and pulse wave analysis (CR2000, Hypertension Diagnostics Inc). We assayed serum and overnight PD effluent for IL-6 and TNFα by ELISA (R&D Systems). Lipid profile, serum albumin, and CRP were also measured.

Volume expansion in peritoneal dialysis (PD) patients is associated with left ventricular hypertrophy. The link between inflammation and hypervolemia has not been extensively studied. The aim of this study was to determine if an association exists between hypervolemia and markers of inflammation in PD patients.

Large differences exist within CKD patients on haemodialysis, from relatively active transplant candidates (mobile CKD patients) to those who are sedentary and depend on healthcare support. Even the healthiest patients display frequent changes in hydration status and may show signs of cell membrane damage.