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Renal Failure - Dialysis

Kidney an organ responsible for filtering blood and electrolytes which are removed as waste products including excess water in a form of urine. Most important waste is generated by the breakdown of proteins. Many diseases contribute to kidney damage eventually leading to renal failure. Kidney failure leads to uraemia (build up of urea and other waste products) and other chemical disturbances in the blood and tissues, leading to symptom of varying severity.

Chronic Kidney failure may progress over time to an advance life-threatening condition called end stage kidney failure. In chronic kidney failure the typical treatment is dialysis, which involves removing excess fluids and toxins from the body.

Two methods of dialysis exist, Haemodialysis and peritoneal dialysis. Haemodialysis is removing blood from the body, which pumped through a filtering machine returning the blood to the body purified. In Peritoneal dialysis fluid mixture of salt and glucose are injected into the abdomen attracting toxin waste which is then drained out of the body. In both cases the body’s fluid volume are adjusted.

Some characteristics changes on Body Composition in patients with renal failure


Monitoring Body Composition

BioScan analysis can improve clinical management in patients with end stage renal disease (ESRD) who are undergoing dialysis. Intermittent fluctuation in hydration status and plasma salt concentrations or the inability to excrete excess water is characteristic in End-Stage Renal Disease patients undergoing dialysis.

Depending on the efficiency of dialysis and patient the alterations in fluid volume can range from oedema with cardiopulmonary congestion to dehydration and hypotension.

Raid transcellular shift of water between the extracellular (ECW) and Intracellular water (ICW) compartments occur during Haemodialysis (HD) due to the removal of 1 to 4 litres of fluid over an average period of 4 hours.

In peritoneal dialysis (PD) between 1 to 3 litres of fluid dwell either intermittently or continuously in the peritoneum, thus producing segmental accumulation of dialysate.

Values of TBW/FM ranged from 75% and 77% and Protein/FFM between 18% and 21% in both men and women that were on Haemodialysis or peritoneal dialysis. What was found was total body protein both in male and female haemodialysis patients was lower that that of group.

Reduction in Fat Mass (FM) and particularly in Body Cell Mass (BCM) which are frequently accompanied by an increase in Extracellular fluid (ECF) are alterations of Body Composition typical for malnutrition.

BioScan measurements of Fat Free Mass (FFM) and Fat (Fat Mass) can help to detect malnourished patients and those who are most at risk from becoming malnourished. Malnutrition and depletion of lean Body Mass (LBM) has been shown to be a significant risk factor for increased mortality rates among patients undergoing dialysis.

The routine use of Maltron Analysers as screening tool could help identify these diseases at earlier stage helping implement effect treatment.