Bioelectrical impedance analysis and physical function improved risk prediction for cardiac dysfunction in hemodialysis patients

TL;DR

This study shows that combining bioelectrical impedance analysis and physical function tests improves the prediction of heart problems in hemodialysis patients.

Contribution

The study demonstrates that BIA and physical function metrics enhance cardiac risk prediction in hemodialysis patients beyond traditional biomarkers.

Findings

Natural gait speed and NT-proBNP were independent predictors of impaired systolic function.

Total body water and NT-proBNP predicted impaired diastolic function effectively.

Combining BIA and physical function metrics improved risk prediction accuracy.

Abstract

Cardiovascular disease is the leading cause of death in maintenance hemodialysis (MHD) patients. This cross-sectional study investigated the associations between bioelectrical impedance analysis (BIA) parameters, physical function, and cardiac function in MHD patients, with the aim of identifying predictors of cardiac dysfunction.

The study included 130 MHD patients from Shanghai Ninth People’s Hospital on December 2022. BIA measurements were executed using the Body Composition Monitor. Physical function was assessed by handgrip strength and natural gait speed. Cardiac systolic and diastolic functions were evaluated by echocardiography. Univariate and multivariable logistic regression analyses were performed to identify determinants of cardiac dysfunction.

Mean age of all participants was 62.39 ± 13.91 years old while 78 (60%) were male. Univariate and multivariable logistic regression analyses were performed to identify determinants of cardiac dysfunction. Multivariable analysis revealed that NT-proBNP (odds ratio [OR], 1.098; 95% CI, 1.011-1.193; P = 0.027) and natural gait speed (OR, 0.002; 95% CI, 0.001-0.528; P = 0.033) were independent determinants of impaired systolic function. Their combination had a high predictive value (area under the curve [AUC] = 0.854; P < 0.001). Total body water (OR, 1.104; 95% CI, 1.010-1.206; P = 0.029) and NT-proBNP (OR, 1.078; 95% CI, 1.010-1.151; P = 0.025) were significant determinants of impaired diastolic function, with the combined prediction (AUC = 0.746; P < 0.001) outperforming either marker alone.

BIA and physical function parameters improved risk stratification beyond conventional biomarkers, providing practical tools for screening cardiac risk in MHD patients.

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