Benefits on bioelectrical impedance assessment of dry weight in hemodialysis patients: a Meta-analysis

Objective To explorethe clinical value and long-term survival benefits of bioelectrical impedance analysis(BIA) in evaluating dry weight in hemodialysis(HD) patients.Methods All randomized controlled trials comparing BIA and clinical assessment methods for evaluating the capacity status of HD patients was searched for a systematic review and meta-analysis.Results Meta-analysis indicated that using BIA for assessing dry weight in HD patients failed to lower all-cause mortalityRR=0.93,95%CI(0.74,1.16),P=0.52,all-cause hospitalization rateRR=0.90,95%CI(0.57,1.42),P=0.65,the incidence of cardiovascular eventsRR=0.71,95%CI(0.47,1.06),P=0.09and the incidence of intradialytic hypotensionRR=0.96,95%CI(0.91,1.02),P=0.22.However,it helped to reduce systolic blood pressure(SBP) pre-dialysisMD=-3.99,95%CI(-6.25,-1.73),P=0.0005,left ventricular mass index(LVMI)SMD=-0.24,95%CI(-0.42,-0.05),P=0.01and pulse wave velocityMD=-2.03,95%CI(-3.36,-0.69),P=0.003.Conclusion Comparing with clinical evaluation methods,no significant difference existed in the reductions of all-cause mortality,all-cause hospitalization rate,incidence of cardiovascular events and intradialytic hypotension when using BIA for assessing dry weight in HD patients.However,it can improve pre-dialysis SBP,reduce LVMI and arterial stiffness and boost patient quality-of-life.