Classification of Hydration in Clinical Conditions: Indirect and Direct Approaches Using Bioimpedance
1
Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND 58202-7166, USA
2
Nephrology Service, University Hospital of Grand Canary and Faculty of Science, University Los Palmas, 35019 Los Palmas, Grand Canary, Spain
3
Antonio Talluri, Fatbyte, Inc., 50012 Bagno a Ripoli, Florence, Italy
4
Department of Electronic Engineering, Universitat Politècnica de Catalunya, 08034 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(4), 809; https://doi.org/10.3390/nu11040809
Received: 5 March 2019
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Revised: 6 April 2019
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Accepted: 8 April 2019
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Published: 10 April 2019
(This article belongs to the Special Issue Hydration and Health: Scientific Evidence and Recommendations)
Although the need to assess hydration is well recognized, laboratory tests and clinical impressions are impractical and lack sensitivity, respectively, to be clinically meaningful. Different approaches use bioelectrical impedance measurements to overcome some of these limitations and aid in the classification of hydration status. One indirect approach utilizes single or multiple frequency bioimpedance in regression equations and theoretical models, respectively, with anthropometric measurements to predict fluid volumes (bioelectrical impedance spectroscopy—BIS) and estimate fluid overload based on the deviation of calculated to reference extracellular fluid volume. Alternatively, bioimpedance vector analysis (BIVA) uses direct phase-sensitive measurements of resistance and reactance, measured at 50 kHz, normalized for standing height, then plotted on a bivariate graph, resulting in a vector with length related to fluid content, and direction with phase angle that indexes hydration status. Comparison with healthy population norms enables BIVA to classify (normal, under-, and over-) and rank (change relative to pre-treatment) hydration independent of body weight. Each approach has wide-ranging uses in evaluation and management of clinical groups with over-hydration with an evolving emphasis on prognosis. This review discusses the advantages and limitations of BIS and BIVA for hydration assessment with comments on future applications.
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Keywords:
fluid overload; resistance; reactance; bioelectrical impedance vector analysis; bioelectrical impedance spectroscopy; malnutrition
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MDPI and ACS Style
Lukaski, H.C.; Vega Diaz, N.; Talluri, A.; Nescolarde, L. Classification of Hydration in Clinical Conditions: Indirect and Direct Approaches Using Bioimpedance. Nutrients 2019, 11, 809. https://doi.org/10.3390/nu11040809
AMA Style
Lukaski HC, Vega Diaz N, Talluri A, Nescolarde L. Classification of Hydration in Clinical Conditions: Indirect and Direct Approaches Using Bioimpedance. Nutrients. 2019; 11(4):809. https://doi.org/10.3390/nu11040809
Chicago/Turabian StyleLukaski, Henry C., Nicanor Vega Diaz, Antonio Talluri, and Lexa Nescolarde. 2019. "Classification of Hydration in Clinical Conditions: Indirect and Direct Approaches Using Bioimpedance" Nutrients 11, no. 4: 809. https://doi.org/10.3390/nu11040809
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