Applications of Bioimpedance to End Stage Renal Disease (ESRD)

This chapter develops a thorough review of the methods and techniques used for the analysis of body composition of renal patients based on bioimpedance measurements. The work ranges from the physical principles, to bioelectric models of human body, instrumentation, configurations in the position of electrodes, equations to calculate body composition, bioimpedance nephrological applications and clinical analysis of results. This text provides a multidisciplinary approach that will allow the reader to understand and comprehend this kind of technology, so it can be used both by engineers as a basis for the development of bioimpedance medical devices, and by medical staff to apply the bioimpedance analysis techniques in a better control and management of patients with ESRD.

[1]  P. Deurenberg,et al.  Determination of intracellular water by multifrequency bioelectrical impedance. , 1995, Annals of nutrition & metabolism.

[2]  N. Levin,et al.  Current state of bioimpedance technologies in dialysis. , 2007, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[3]  Eninia Gi,et al.  A portable rheograph for clinical studies , 1961 .

[4]  A. Piccoli,et al.  A new method for monitoring hydration at high altitude by bioimpedance analysis. , 1996, Medicine and science in sports and exercise.

[5]  R. W. Lau,et al.  The dielectric properties of biological tissues: III. Parametric models for the dielectric spectrum of tissues. , 1996, Physics in medicine and biology.

[6]  C. Pichard,et al.  Single prediction equation for bioelectrical impedance analysis in adults aged 20--94 years. , 2001, Nutrition.

[7]  David S. Holder,et al.  Electrical Impedance Tomography : Methods, History and Applications , 2004 .

[8]  W. Howell,et al.  Bioimpedance spectroscopy for clinical assessment of fluid distribution and body cell mass. , 2007, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[9]  Y Schutz,et al.  Fat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y , 2002, International Journal of Obesity.

[10]  J. Matthie,et al.  Use of bioimpedance spectroscopy to determine extracellular fluid, intracellular fluid, total body water, and fat-free mass. , 1993, Basic life sciences.

[11]  C.E.F. Amaral,et al.  Effects of glucose in blood and skin impedance spectroscopy , 2007, AFRICON 2007.

[12]  J Rosell,et al.  Bioelectrical impedance vector analysis in haemodialysis patients: relation between oedema and mortality , 2004, Physiological measurement.

[13]  P S Davies,et al.  Measurement of total body water by bioelectrical impedance in chronic renal failure. , 1996, European journal of clinical nutrition.

[14]  C. Tetta,et al.  Towards improved cardiovascular management: the necessity of combining blood pressure and fluid overload. , 2008, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[15]  Jing Liu,et al.  Calf Bioimpedance Ratio Improves Dry Weight Assessment and Blood Pressure Control in Hemodialysis Patients , 2010, American Journal of Nephrology.

[16]  R. Patterson,et al.  Body fluid determinations using multiple impedance measurements , 1989, IEEE Engineering in Medicine and Biology Magazine.

[17]  Peter Aberg,et al.  Minimally invasive electrical impedance spectroscopy of skin exemplified by skin cancer assessments , 2003, Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439).

[18]  J. Passauer,et al.  Evaluation of clinical dry weight assessment in haemodialysis patients using bioimpedance spectroscopy: a cross-sectional study. , 2010, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[19]  S. Prakash,et al.  Central, Peripheral, and Other Blood Volume Changes During Hemodialysis , 2002, ASAIO journal.

[20]  C Gabriel,et al.  The dielectric properties of biological tissues: I. Literature survey. , 1996, Physics in medicine and biology.

[21]  S. Heymsfield,et al.  Segment-specific resistivity improves body fluid volume estimates from bioimpedance spectroscopy in hemodialysis patients. , 2006, Journal of applied physiology.

[22]  A. Bosy-Westphal,et al.  A whole-body model to distinguish excess fluid from the hydration of major body tissues. , 2007, The American journal of clinical nutrition.

[23]  D. Marcelli,et al.  The mortality risk of overhydration in haemodialysis patients , 2009, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[24]  M. Dittmar,et al.  Evaluation of Different Methods for Assessing Intracellular Fluid in Healthy Older People: A Cross‐Validation Study , 2002, Journal of the American Geriatrics Society.

[25]  A. P. Heidenheim,et al.  Preserving Central Blood Volume: Changes in Body Fluid Compartments During Hemodialysis , 2001, ASAIO journal.

[26]  Francis Dumler,et al.  Best Method for Estimating Urea Volume of Distribution: Comparison of Single Pool Variable Volume Kinetic Modeling Measurements with Bioimpedance and Anthropometric Methods , 2004, ASAIO journal.

[27]  M. N. Souza,et al.  A comparison between impedance measured by a commercial analyzer and your value adjusted by a theoretical model in body composition evaluation , 2001, 2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[28]  D. Hans,et al.  Prevalence of low fat-free mass index and high and very high body fat mass index following lung transplantation , 2003, Acta Diabetologica.

[29]  K. Cole.  Membranes, ions, and impulses : a chapter of classical biophysics , 1968 .

[30]  M. Elia,et al.  Bioelectrical impedance analysis--part I: review of principles and methods. , 2004, Clinical nutrition.

[31]  PL Cox-Reijven,et al.  Validation of bio-impedance spectroscopy: Effects of degree of obesity and ways of calculating volumes from measured resistance values , 2000, International Journal of Obesity.

[32]  B. Heitmann.  Evaluation of body fat estimated from body mass index, skinfolds and impedance. A comparative study. , 1990, European journal of clinical nutrition.

[33]  S. Pastan,et al.  Total body water measured by bioelectrical impedance in patients after hemodialysis. Comparison with urea kinetics. , 1992, ASAIO journal.

[34]  Peter Rolfe,et al.  Non-invasive physiological measurements , 1979 .

[35]  Sandro Giannini,et al.  Limb fat-free mass and fat mass reference values by dual-energy X-ray absorptiometry (DEXA) in a 20-80 year-old Italian population. , 2008, Clinical nutrition.

[36]  W. Soichi,et al.  Guidelines for limiting exposure to electric fields induced by movement of the human body in a static magnetic field and by time-varying magnetic fields below 1 Hz. , 2014, Health physics.

[37]  J. Songer,et al.  Tissue Ischemia Monitoring Using Impedance Spectroscopy: Clinical Evaluation , 2001 .

[38]  S. Kun,et al.  Tissue ischemia monitoring using impedance spectroscopy: evaluation of neural networks for ischemia estimation , 2001, Proceedings of the IEEE 27th Annual Northeast Bioengineering Conference (Cat. No.01CH37201).

[39]  Hélène Morel,et al.  Body fluid volumes measurements by impedance: A review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods. , 2008, Medical engineering & physics.

[40]  A. A. Ahmed,et al.  Assessment of the nutritional status of end-stage renal disease patients on maintenance hemodialysis. , 2004, Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia.

[41]  A. Piccoli,et al.  Impedance vector distribution by sex, race, body mass index, and age in the United States: standard reference intervals as bivariate Z scores. , 2002, Nutrition.

[42]  Rahima Jamal,et al.  Permanent renal failure induced by pentastarch , 2008, NDT plus.

[43]  Sverre Grimnes,et al.  Bioimpedance and Bioelectricity Basics , 2000 .

[44]  Javier Rosell,et al.  Comparison of segmental with whole-body impedance measurements in peritoneal dialysis patients. , 2008, Medical engineering & physics.

[45]  R. Patterson,et al.  Development and evaluation of an impedance cardiac output system. , 1966, Aerospace medicine.

[46]  D. Schoeller,et al.  Estimation of total body water by bioelectrical impedance analysis. , 1986, The American journal of clinical nutrition.

[47]  P. Deurenberg,et al.  Sex and age specific prediction formulas for estimating body composition from bioelectrical impedance: a cross-validation study. , 1991, International journal of obesity.

[48]  Stefano Rinaldi,et al.  A prospective multicentre study of the nutritional status in children on chronic peritoneal dialysis. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[49]  P. Watson,et al.  Total body water volumes for adult males and females estimated from simple anthropometric measurements. , 1980, The American journal of clinical nutrition.

[50]  K. Ellis,et al.  Human body composition : in vivo methods, models, and assessment , 1993 .

[51]  B. Charra,et al.  Fluid balance, dry weight, and blood pressure in dialysis , 2007, Hemodialysis international. International Symposium on Home Hemodialysis.

[52]  Yuxiang Yang,et al.  New Tetrapolar Method for Complex Bioimpedance Measurement: Theoretical Analysis and Circuit Realization , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[53]  V. Heyward,et al.  Predictive accuracy of bioelectrical impedance in estimating body composition of Native American women. , 1994, The American journal of clinical nutrition.

[54]  Marianne Fenech,et al.  Continuous Monitoring of Plasma, Interstitial, and Intracellular Fluid Volumes in Dialyzed Patients by Bioimpedance and Hematocrit Measurements , 2002, ASAIO journal.

[55]  Orazio Tomarchio,et al.  To treat or not to treat: comparison of different criteria used to determine whether weight loss is to be recommended , 2008, Nutrition Journal.

[56]  A. Maran,et al.  Non-invasive glucose monitoring: assessment of technologies and devices according to quantitative criteria. , 2007, Diabetes research and clinical practice.

[57]  T. Parve,et al.  Modification of pulse wave signals in electrical bioimpedance analyzers for implantable medical devices , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[58]  A. Piccoli,et al.  A new method for monitoring body fluid variation by bioimpedance analysis: the RXc graph. , 1994, Kidney international.

[59]  L. Ellegård,et al.  Body fluid volume determination via body composition spectroscopy in health and disease , 2006, Physiological measurement.

[60]  A. Piccoli,et al.  [Conventional and vectorial analysis of bioimpedance in clinical practice]. , 2002, Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia.

[61]  W. Hannan,et al.  Comparison of bio-impedance spectroscopy and multi-frequency bio-impedance analysis for the assessment of extracellular and total body water in surgical patients. , 1995, Clinical science.

[62]  J. Matthie,et al.  Predicting body cell mass with bioimpedance by using theoretical methods: a technological review. , 1997, Journal of applied physiology.

[63]  Martin Wilkie,et al.  Determination of urea distribution volume for Kt/V assessed by conductivity monitoring. , 2003, Kidney international.

[64]  Claude Pichard,et al.  Sedentarism affects body fat mass index and fat-free mass index in adults aged 18 to 98 years. , 2004, Nutrition.

[65]  R. Baumgartner,et al.  Body composition in elderly people: effect of criterion estimates on predictive equations. , 1991, The American journal of clinical nutrition.

[66]  W. Hannan,et al.  Evaluation of multi-frequency bio-impedance analysis for the assessment of extracellular and total body water in surgical patients. , 1994, Clinical science.

[67]  J. Nyboer,et al.  Electrical Impedance Plethysmography: A Physical and Physiologic Approach to Peripheral Vascular Study , 1950, Circulation.

[68]  M Y Jaffrin,et al.  Fluid volumes determination by impedance spectroscopy and hematocrit monitoring: application to pediatric hemodialysis. , 2001, Artificial organs.

[69]  K Widhalm,et al.  Underestimation of percentage fat mass measured by bioelectrical impedance analysis compared to dual energy X-ray absorptiometry method in obese children , 2001, European Journal of Clinical Nutrition.

[70]  J. Matthie.  Second generation mixture theory equation for estimating intracellular water using bioimpedance spectroscopy. , 2005, Journal of applied physiology.

[71]  G. Sergi,et al.  Accuracy of bioelectrical impedance analysis in estimation of extracellular space in healthy subjects and in fluid retention states. , 1994, Annals of nutrition & metabolism.

[72]  C. Rode,et al.  A new technique for establishing dry weight in hemodialysis patients via whole body bioimpedance. , 2002, Kidney international.

[73]  L. Ward,et al.  Improved prediction of extracellular and total body water using impedance loci generated by multiple frequency bioelectrical impedance analysis , 1993, Physics in medicine and biology.

[74]  J. Herbertz.  Comment on the ICNIRP guidelines for limiting exposure to time-varying electric, magnetic, and electromagnetic fields (up to 300 GHz) , 1998, Health physics.

[75]  B. Heitmann,et al.  Prediction of body water and fat in adult Danes from measurement of electrical impedance. A validation study. , 1990, International journal of obesity.

[76]  D. C. Simpson,et al.  Correlation of whole-body impedance with total body water volume. , 1969, Journal of applied physiology.

[77]  D. Schoeller,et al.  The validity of bioelectrical impedance models in clinical populations. , 2004, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[78]  S. Heymsfield,et al.  Estimation of total-body and limb muscle mass in hemodialysis patients by using multifrequency bioimpedance spectroscopy. , 2005, The American journal of clinical nutrition.

[79]  Danilo Demarchi,et al.  Blood cell counting by means of impedance measurements in a microsystem device , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[80]  Paul Fein,et al.  Enrollment fluid status is independently associated with long-term survival of peritoneal dialysis patients. , 2008, Advances in peritoneal dialysis. Conference on Peritoneal Dialysis.

[81]  John G. Webster,et al.  An Impedance Camera for Spatially Specific Measurements of the Thorax , 1978, IEEE Transactions on Biomedical Engineering.

[82]  A. Książek,et al.  Thoracic Impedance Measurements During Orthostatic Change Test and During Hemodialysis in Hemodialyzed Patients , 2004, ASAIO journal.

[83]  P. Wabel,et al.  Importance of Whole-Body Bioimpedance Spectroscopy for the Management of Fluid Balance , 2009, Blood Purification.

[84]  B. Rubinsky,et al.  Assessment of the Viability of Transplant Organs with 3D Electrical Impedance Tomography , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[85]  Siyang Zheng,et al.  Human Blood Cell Sensing with Platinum Black Electroplated Impedance Sensor , 2007, 2007 2nd IEEE International Conference on Nano/Micro Engineered and Molecular Systems.

[86]  Ingvar Bosaeus.  Clinical Nutrition – The Nutrition Society Textbook , 2005 .

[87]  P. C. Pandey,et al.  Wavelet Based Cancellation of Respiratory Artifacts in Impedance Cardiography , 2007, 2007 15th International Conference on Digital Signal Processing.

[88]  M. Tabrizian,et al.  Nondestructive Online In Vitro Monitoring of Pre-Osteoblast Cell Proliferation Within Microporous Polymer Scaffolds , 2007, IEEE Transactions on NanoBioscience.

[89]  P. Chamney,et al.  A comparison of methods for determining urea distribution volume for routine use in on-line monitoring of haemodialysis adequacy. , 2008, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[90]  Yves Schutz,et al.  Is Lean Body Mass Decreased after Obesity Treatment by Adjustable Gastric Banding? , 2007, Obesity surgery.

[91]  John G. Webster,et al.  Medical Instrumentation: Application and Design , 1997 .

[92]  Steffen Leonhardt,et al.  A Novel Bioimpedance Technique to Monitor Fluid Volume State During Hemodialysis Treatment , 2010, ASAIO journal.

[93]  M. Elia,et al.  Bioelectrical impedance analysis-part II: utilization in clinical practice. , 2004, Clinical nutrition.

[94]  E. Atzler,et al.  Über ein neues Verfahren zur Darstellung der Herztätigkeit (Dielektrographie) , 1932, Arbeitsphysiologie.

[95]  K J Ellis,et al.  Measurement of body water by multifrequency bioelectrical impedance spectroscopy in a multiethnic pediatric population. , 1999, The American journal of clinical nutrition.

[96]  Shumei S. Sun,et al.  Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model for use in epidemiologic surveys. , 2003, The American journal of clinical nutrition.

[97]  Sharon A. Hoeger,et al.  Principles and Labs for Fitness and Wellness , 1996 .

[98]  Reilly Jp.  Comments concerning "Guidelines for limiting exposure to time-varying electric, magnetic, and electromagnetic fields (up to 300 GHz)". , 1999 .

[99]  T. Kao,et al.  On Measuring the Changes in Stroke Volume from a Peripheral Artery by Means of Electrical Impedance Plethysmography , 2008, 2008 2nd International Conference on Bioinformatics and Biomedical Engineering.

[100]  E. Bois-Reymond.  Untersuchungen über thierische Elektricität , 1848 .

[101]  Alfred K. Cheung,et al.  Risk Factors for Hypertension in Chronic Hemodialysis Patients: Baseline Data from the HEMO Study , 2001, American Journal of Nephrology.

[102]  María de los Ángeles Espinosa-Cuevas,et al.  Vectores de impedancia bioeléctrica para la composición corporal en población mexicana , 2007 .

[103]  Roland Zengerle,et al.  Capacitive on-line hematocrit sensor design based on impedance spectroscopy for use in hemodialysis machines , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[104]  J. Ibeas,et al.  Monitoring Cole-Cole Parameters During Haemodialysis (HD) , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[105]  Alexander S. Goldfarb-Rumyantzev,et al.  Familiality of Cardiovascular Mortality in End-Stage Renal Disease Patients , 2008, American Journal of Nephrology.

[106]  G. Sesti,et al.  New insights into body composition assessment in obese women. , 1999, Canadian journal of physiology and pharmacology.