Bioelectrical impedance analysis for assessing hydration status in patients undergoing maintenance hemodialysis

doi:10.5527/wjn.v15.i2.118360

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Nephrol. Jun 25, 2026; 15(2): 118360
Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.118360

Table 1 General characteristics of the patients, n (%)/mean ± SD/median (interquartile rage)

Variable	n = 54
Sex (male)	32 (59.3)
Age (years)	57.6 ± 13.1
Hemodialysis vintage (months)	21.5 (5.0-62.2)
Diabetic	21 (38.9)
Vascular access
Arteriovenous fistula	37 (68.6)
Double-lumen catheter	17 (31.5)
Creatinine (mg/dL)	8.91 ± 3.56
Urea (mg/dL)	111.5 (97.0-122.7)
C-reactive protein (mg/dL)	0.48 (0.17-1.21)
Albumin (g/dL)	3.90 ± 0.55
Body mass index (kg/m²)	26.25 ± 5.75
Interdialytic weight gain (kg)	1.94 ± 0.95
Urea clearance index	1.30 ± 0.26

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Table 2 Hydration parameters before and after the hemodialysis session (n = 54), median (interquartile rage)/ mean ± SD

Parameters	Before dialysis	After dialysis	P value
SBP (mmHg)	137 (129-161)	143 (124-158)	1.000
DBP (mmHg)	76 (67-88)	78 (70-98)	0.608
Total body water (L)	36.94 ± 7.02	33.27 ± 6.42	< 0.001
Intracellular water (L)	19.06 ± 4.15	18.12 ± 3.92	< 0.001
Intracellular water (%)	51.50 ± 4.48	53.87 ± 5.41	< 0.001
Extracellular water (L)	17.89 ± 3.62	15.15 ± 3.26	< 0.001
Extracellular water (%)	48.49 ± 4.48	45.56 ± 4.68	< 0.001
NT pro-BNP (ng/mL)	0.677 (0.182-2.422)	0.549 (0.138-2.322)	0.002
Overhydration (L)	-0.36 ± 2.93	-3.43 ± 2.57	< 0.001
Overhydration/extracellular water (%)	-3.95 ± 16.80	-25.34 ± 19.88	< 0.001
Extracellular water/weight (%)	24.81 ± 3.36	21.55 ± 2.99	< 0.001

SBP: Systolic blood pressure; DBP: Diastolic blood pressure; NT pro-BNP: N-terminal pro-brain natriuretic peptide.

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Table 3 Correlations of hydration assessment indices with blood pressure and body water parameters before dialysis session (n = 54)

Pre-dialysis parameter		OH	OH/ECW	ECW/body weight
SBP (mmHg)	r	0.374¹	0.352¹	0.217
SBP (mmHg)	P value	0.005¹	0.009¹	0.115
DBP (mmHg)	r	0.316¹	0.297³	0.132
DBP (mmHg)	P value	0.020¹	0.029³	0.342
IDWG (kg)	r	0.482¹	0.505²	0.354¹
IDWG (kg)	P value	< 0.001¹	< 0.001²	0.009¹
TBW (L)	r	0.517²	0.553²	0.089
TBW (L)	P value	< 0.001²	< 0.001²	0.524
ICW (L)	r	0.395¹	0.432¹	-0.104
ICW (L)	P value	0.003¹	< 0.001¹	0.453
ICW (%)	r	-0.115	-0.106	-0.429
ICW (%)	P value	0.409	0.446	0.001
ECW (L)	r	0.540²	0.564²	0.289³
ECW (L)	P value	< 0.001²	< 0.001²	0.034³
ECW (%)	r	0.113	0.104	0.429¹
ECW (%)	P value	0.414	0.452	0.001¹
NT pro BNP (ng/mL)	r	0.181	0.180	0.257
NT pro BNP (ng/mL)	P value	0.228	0.232	0.084

¹Poor correlation.

²Fair correlation.

³Negligible correlation.

SBP: Systolic blood pressure; DBP: Diastolic blood pressure; IDWG: Interdialytic weight gain; TBW: Total body water; ICW: Intracellular water; ECW: Extracellular water; NT pro-BNP: N-terminal pro-brain natriuretic peptide; OH: Overhydration.

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Table 4 Correlations of hydration assessment indices with blood pressure and body water parameters after dialysis session (n = 54)

Post-dialysis parameter		OH	OH/ECW	ECW/body weight
SBP (mmHg)	r	0.520²	0.495¹	0.252
SBP (mmHg)	P value	< 0.001²	< 0.001¹	0.066
DBP (mmHg)	r	0.393¹	0.343¹	0.055
DBP (mmHg)	P value	0.003¹	0.011¹	0.695
IDWG (kg)	r	0.339¹	0.367¹	0.184
IDWG (kg)	P value	0.012¹	0.006¹	0.183
TBW (L)	r	0.364¹	0.548²	0.062
TBW (L)	P value	0.007¹	< 0.001²	0.657
ICW (L)	r	0.235	0.372¹	-0.172
ICW (L)	P value	0.087	0.006¹	0.214
ICW (%)	r	-0.122	-0.162	-0.368¹
ICW (%)	P value	0.378	0.241	0.006¹
ECW (L)	r	0.435¹	0.632²	0.329¹
ECW (L)	P value	0.001¹	< 0.001²	0.015¹
ECW (%)	r	0.216	0.290³	0.559²
ECW (%)	P value	0.117	0.034³	< 0.001²
NT pro BNP (ng/mL)	r	0.310¹	0.269	0.427¹
NT pro BNP (ng/mL)	P value	0.036¹	0.070	0.003¹

¹Poor correlation.

²Fair correlation.

³Negligible correlation.

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Citation: Borges GLS, Mendes LR, Trombim IC, Goes CR, Vogt BP. Bioelectrical impedance analysis for assessing hydration status in patients undergoing maintenance hemodialysis. World J Nephrol 2026; 15(2): 118360
URL: https://www.wjgnet.com/2220-6124/full/v15/i2/118360.htm
DOI: https://dx.doi.org/10.5527/wjn.v15.i2.118360

Borges GLS, Mendes LR, Trombim IC, Goes CR, Vogt BP. Bioelectrical impedance analysis for assessing hydration status in patients undergoing maintenance hemodialysis. World J Nephrol 2026; 15(2): 118360 [DOI: 10.5527/wjn.v15.i2.118360]

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