Kidney Week

Abstract: SA-PO041

Bioelectrical Impedance Analysis to Assess Fluid Balance in Children Undergoing Continuous Kidney Replacement Therapy

Session Information

• AKI: Clinical, Outcomes, and Trials - Management
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Mohan, Shruthi, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Shruthi Mohan, MD, MBBS

• Schablein, Ryan W., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Ryan W. Schablein

• Krallman, Kelli A., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Kelli A. Krallman, MS, RN

• Goldstein, Stuart, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Stuart Goldstein, MD, FASN

• Stanski, Natalja L., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Natalja L. Stanski, MD

Background

Acute kidney injury (AKI) is common in critically ill children and may require continuous renal replacement therapy (CRRT). Accurate fluid balance (FB) assessment during CRRT is important but challenging as traditional methods show limited agreement and variation. BIA has been studied in adults on CRRT, but no data exist in children. We aimed to (1) assess the feasibility of BIA to evaluate FB in pediatric CRRT, and (2) compare it to traditional methods. We hypothesized that bedside and BIA assessments of FB would be discrepant.

Methods

Ongoing single-centered, prospective, observational study of patients 3-25 years (Y) receiving CRRT. We performed BIA (InBody BWA 2.0) at several timepoints (prior to CRRT, Day 2, 4, and 7 or prior to CRRT discontinuation) to measure total body water (mTBW). These values were compared to calculated TBW (cTBW) using the Morgenstern equation, weight (kg), cumulative FB (L), and clinician assessment of FB (nephrology/ICU).

Results

Five included patients (60% males, mean age 15.8Y) contributed 11 BIA measurements. Seven (64%) demonstrated >10% difference between mTBW and cTBW, with an absolute mean difference of 17.5% (SD 14.1%). Temporal trends in mTBW, weight and FB for patients with complete data are shown in Figure1. Concordance of FB assessment was 50% or less for all possible combinations of BIA/nephrology/ICU (Table1).

Conclusion

BIA for assessment of FB in critically ill children receiving CRRT is feasible and discrepant with traditional methods, highlighting its possible role in guiding fluid removal on CRRT.

Funding

• NIDDK Support