Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trials

Managing patient ‘dry weight’ according to clinical standards has deficiencies. Research has focused on the effectiveness of using bioelectrical impedance technology for fluid management in dialysis patients. Whether bioelectrical impedance monitoring can improve dialysis patients prognoses remain c...

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Main Authors: Kaibi Yang, Shujun Pan, Nan Yang, Juan Wu, Yueming Liu, Qiang He
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2203247
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author Kaibi Yang
Shujun Pan
Nan Yang
Juan Wu
Yueming Liu
Qiang He
author_facet Kaibi Yang
Shujun Pan
Nan Yang
Juan Wu
Yueming Liu
Qiang He
author_sort Kaibi Yang
collection DOAJ
description Managing patient ‘dry weight’ according to clinical standards has deficiencies. Research has focused on the effectiveness of using bioelectrical impedance technology for fluid management in dialysis patients. Whether bioelectrical impedance monitoring can improve dialysis patients prognoses remain controversial. We performed a meta-analysis of randomized controlled trials to determine whether bioelectrical impedance was effective in improving dialysis patients prognoses. The primary outcome was all-cause mortality (13.6 ± 9.1 months). Secondary outcomes were left ventricular mass index (LVMI), arterial stiffness assessed using Pulse Wave Velocity (PWV), and N-terminal brain natriuretic peptide precursor (NT-proBNP). Of 4,641 citations retrieved, we identified 15 eligible trials involving 2763 patients divided into experimental (n = 1386) and control (n = 1377) groups. In 14 studies with mortality data, the meta-analysis showed that bioelectrical impedance intervention reduced the risk of all-cause mortality (rate ratios [RR]: 0.71; 95% confidence interval [CI]: 0.51, 0.99; p = .05; I2 = 1%). Subgroup analysis of patients on hemodialysis (RR: 0.72; 95% CI: 0.42, 1.22; p = .22) and peritoneal dialysis (RR: 0.62; 95% CI: 0.35, 1.07; p = .08) showed no significant mortality difference between intervention and control groups. It reduced the risk of all-cause mortality in the Asian population (RR: 0.52; p = .02), and reduced NT-proBNP (mean difference [MD]: −1495.73; p = 0.002; I2=0%) and PWV (MD: −1.55; p = .01; I2=89%). Bioelectrical impedance intervention reduced the LVMI in hemodialysis patients (MD: −12.69; p < .0001; I2=0%). Our analysis shows that in dialysis patients, bioelectrical impedance technology intervention could reduce, but not eliminate, the risk of all-cause mortality. Overall, this technology can improve the prognosis of dialysis patients.
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spelling doaj-art-163c2aec442b4cdca12d41e13448c6cf2025-08-20T02:16:10ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2203247Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trialsKaibi Yang0Shujun Pan1Nan Yang2Juan Wu3Yueming Liu4Qiang He5Urology &amp; Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology &amp; Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology &amp; Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology &amp; Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaUrology &amp; Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, ChinaDepartment of Nephrology, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, ChinaManaging patient ‘dry weight’ according to clinical standards has deficiencies. Research has focused on the effectiveness of using bioelectrical impedance technology for fluid management in dialysis patients. Whether bioelectrical impedance monitoring can improve dialysis patients prognoses remain controversial. We performed a meta-analysis of randomized controlled trials to determine whether bioelectrical impedance was effective in improving dialysis patients prognoses. The primary outcome was all-cause mortality (13.6 ± 9.1 months). Secondary outcomes were left ventricular mass index (LVMI), arterial stiffness assessed using Pulse Wave Velocity (PWV), and N-terminal brain natriuretic peptide precursor (NT-proBNP). Of 4,641 citations retrieved, we identified 15 eligible trials involving 2763 patients divided into experimental (n = 1386) and control (n = 1377) groups. In 14 studies with mortality data, the meta-analysis showed that bioelectrical impedance intervention reduced the risk of all-cause mortality (rate ratios [RR]: 0.71; 95% confidence interval [CI]: 0.51, 0.99; p = .05; I2 = 1%). Subgroup analysis of patients on hemodialysis (RR: 0.72; 95% CI: 0.42, 1.22; p = .22) and peritoneal dialysis (RR: 0.62; 95% CI: 0.35, 1.07; p = .08) showed no significant mortality difference between intervention and control groups. It reduced the risk of all-cause mortality in the Asian population (RR: 0.52; p = .02), and reduced NT-proBNP (mean difference [MD]: −1495.73; p = 0.002; I2=0%) and PWV (MD: −1.55; p = .01; I2=89%). Bioelectrical impedance intervention reduced the LVMI in hemodialysis patients (MD: −12.69; p < .0001; I2=0%). Our analysis shows that in dialysis patients, bioelectrical impedance technology intervention could reduce, but not eliminate, the risk of all-cause mortality. Overall, this technology can improve the prognosis of dialysis patients.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2203247Dialysisbioimpedancefluid overloadprognosis
spellingShingle Kaibi Yang
Shujun Pan
Nan Yang
Juan Wu
Yueming Liu
Qiang He
Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trials
Renal Failure
Dialysis
bioimpedance
fluid overload
prognosis
title Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trials
title_full Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trials
title_fullStr Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trials
title_full_unstemmed Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trials
title_short Effect of bioelectrical impedance technology on the prognosis of dialysis patients: a meta-analysis of randomized controlled trials
title_sort effect of bioelectrical impedance technology on the prognosis of dialysis patients a meta analysis of randomized controlled trials
topic Dialysis
bioimpedance
fluid overload
prognosis
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2203247
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