Journals / Medical Records / 2026 / Sayı: 1

Impact of Hemodialysis on Body Fluid Distribution and Phase Angle in Chronic Renal Failure: Insights from a Cross-Sectional Study

Kronik Böbrek Hastalığında Hemodiyalizin Vücut Sıvı Dağılımı ve Faz Açısı Üzerine Etkisi: Kesitsel Bir Çalışmadan Elde Edilen Bulgular

Hasan Esat Yücel(Kırşehir Ahi Evran University, Faculty of Medicine, Department of Internal Medicine)0000-0001-7788-0227
Tufan Ulcay(Kırşehir Ahi Evran University, Faculty of Medicine, Department of Anatomy)0000-0003-2203-3850
Ozkan Gorgulu(Kırşehir Ahi Evran University, Faculty of Medicine, Department of Biostatistics and Medical Informatics)0000-0002-6802-4450
Aydın Güçlü(Department of Nephrology, Kırşehir Training and Research Hospital)0000-0002-7853-2141
Ruken Öncü(Kırşehir Ahi Evran University, Faculty of Medicine, Department of Anatomy)0009-0001-4896-7822
Emre Uğuz(Kırşehir Ahi Evran University, Faculty of Medicine, Department of Anatomy)0000-0001-7813-3290
Muhammed Fırat Aladağ(Kırşehir Ahi Evran University, Faculty of Medicine, Department of Anatomy)0009-0005-5332-4783
Mesut Çeliker(Department of Internal Medicine, Kırşehir Training and Research Hospital)0000-0003-1240-657X
Kadirhan Doğan(Kapadokya University, College of Health Sciences)0000-0002-0249-1435
Mesut Sungur(Kırşehir Ahi Evran University, Faculty of Medicine, Department of Internal Medicine)0000-0002-2455-9824
Ahmet Uzun(Ondokuz Mayıs University, Faculty of Medicine, Department of Anatomy)0000-0003-4147-3798
Pages
—
Publication Date
2026-03-21
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: HD leads to significant shifts in body fluid compartments, resulting in reduced hydration status and increased segmental phase angles values.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: Bioelectrical impedance analysis (BIA) is a widely used, non-invasive technique that provides valuable information about phase angle (PhA) and hydration status, both of which are indicators of cellular health.
📊
Key Findings & Data:Using a multi-frequency (5, 50, 250 kHz) BIA device, segmental PhA and body fluid composition were measured.
💡
Conclusion & Impact:Conclusion: HD leads to significant shifts in body fluid compartments, resulting in reduced hydration status and increased segmental phase angles values.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Kronik böbrek yetmezliği · hemodiyaliz · faz açıları

Abstract

Aim: Bioelectrical impedance analysis (BIA) is a widely used, non-invasive technique that provides valuable information about phase angle (PhA) and hydration status, both of which are indicators of cellular health. In patients with chronic renal failure (CRF), fluid balance is often disrupted due to impaired kidney function. This study aimed to evaluate the effects of hemodialysis (HD) on segmental PhA values and body fluid distribution in patients with CRF. Material and Methods: Patients receiving HD for CRF were enrolled. Using a multi-frequency (5, 50, 250 kHz) BIA device, segmental PhA and body fluid composition were measured. Results: Post-dialysis measurements revealed a significant increase in phase angles across all examined segments. Concurrently, extracellular water (ECW), intracellular water (ICW) and total body water (TBW) volumes significantly decreased, whereas both ECW/TBW and ECW/ICW ratios increased. Conclusion: HD leads to significant shifts in body fluid compartments, resulting in reduced hydration status and increased segmental phase angles values.

Özet

Özet Giriş: Biyoelektrik empedans analizi (BIA), faz açısı (PhA) ve hidrasyon durumu hakkında değerli bilgiler sağlayan, yaygın olarak kullanılan, non-invaziv bir tekniktir. Bu iki parametre hücresel sağlığın göstergeleridir. Kronik böbrek yetmezliği (KBY) olan hastalarda, böbrek fonksiyonlarındaki bozulmaya bağlı olarak sıvı dengesi sıklıkla bozulur. Bu çalışma, KBY’li hastalarda hemodiyalizin (HD) segmental PhA değerleri ve vücut sıvı dağılımı üzerindeki etkilerini değerlendirmeyi amaçladı. Yöntem: KBY nedeniyle HD tedavisi alan hastalar çalışmaya dahil edildi. Çok frekanslı (5, 50, 250 kHz) BIA cihazı kullanılarak segmental PhA ve vücut sıvı kompozisyonu ölçümleri yapıldı. Bulgular: Diyaliz sonrası ölçümlerde, incelenen tüm segmentlerde faz açıları anlamlı şekilde arttı. Aynı zamanda hücre dışı sıvı (ECW), hücre içi sıvı (ICW) ve toplam vücut sıvısı (TBW) hacimleri anlamlı olarak azaldı; buna karşın ECW/TBW ve ECW/ICW oranlarında artış gözlendi. Sonuç: HD, vücut sıvı kompartmanlarında anlamlı değişimlere yol açarak hidrasyon durumunun azalmasına ve segmental faz açı değerlerinin artmasına neden olmaktadır.

🔖

Cite This Article

Yücel, H. E., Ulcay, T., Gorgulu, O., Güçlü, A., Öncü, R., Uğuz, E., Aladağ, M. F., Çeliker, M., Doğan, K., Sungur, M., Uzun, A. (2026). Impact of Hemodialysis on Body Fluid Distribution and Phase Angle in Chronic Renal Failure: Insights from a Cross-Sectional Study. Medical Records, Sayı: 1. https://doi.org/10.37990/medr.1764330

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (31)

  1. Dai P, Chang W, Xin Z, et al. Retrospective study on the influencing factors and prediction of hospitalization expenses for chronic renal failure in China based on random forest and LASSO regression. Front Public Health. 2021;9:678276.
  2. Hashmi MF, Benjamin O, Lappin SL. End-stage renal disease. 2018
  3. Scott IA, Scuffham P, Gupta D, et al. Going digital: a narrative overview of the effects, quality and utility of mobile apps in chronic disease self-management. Aust Health Rev. 2018;44:62–82.
  4. Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet. 2012;379:815–22.
  5. Sgambat K, Cheng YI, Charnaya O, Moudgil A. The prevalence and outcome of children with failure to thrive after pediatric kidney transplantation. Pediatr Transplant. 2019;23:e13321.
  6. Chuasuwan A, Pooripussarakul S, Thakkinstian A, et al. Comparisons of quality of life between patients underwent peritoneal dialysis and hemodialysis: a systematic review and meta-analysis. Health Qual Life Outcomes. 2020;18:191.
  7. Çalapkorur S, İradeli E. Hemodiyaliz hastalarında beslenme durumunun değerlendirilmesinde yeni bir yöntem: faz açısı. Cumhuriyet Univ Sağlık Bilim Enst Derg. 2023;8:58–64.
  8. Vadakedath S, Kandi V. Dialysis: a review of the mechanisms underlying complications in the management of chronic renal failure. Cureus. 2017;9:e1603.
  9. Ng JK-C, Lau SL-F, Chan GC-K, et al. Nutritional assessments by bioimpedance technique in dialysis patients. Nutrients. 2023;16:15.
  10. Zoccali C, Moissl U, Chazot C, et al. Chronic fluid overload and mortality in ESRD. J Am Soc Nephrol. 2017;28:2491–7.
  11. Van Biesen W, Verger C, Heaf J, et al. Evolution over time of volume status and PD-related practice patterns in an incident peritoneal dialysis cohort. Clin J Am Soc Nephrol. 2019;14:882–93.
  12. Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis part II: utilization in clinical practice. Clin Nutr. 2004;23:1430–53.
  13. Norman K, Wirth R, Neubauer M, et al. The bioimpedance phase angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer. J Am Med Dir Assoc. 2015;16:173. e117–22.
  14. Zeng Y, Xu Y, Zhang B, et al. Clinical prognostic role of bioimpedance phase angle in diabetic and non-diabetic hemodialysis patients. Asia Pac J Clin Nutr. 2022;31:619–25.
  15. Kwan BC-H, Szeto C-C, Chow K-M, et al. Bioimpedance spectroscopy for the detection of fluid overload in Chinese peritoneal dialysis patients. Perit Dial Int. 2014;34:409–16.
  16. Ronco C, Verger C, Crepaldi C, et al. Baseline hydration status in incident peritoneal dialysis patients: the initiative of patient outcomes in dialysis (IPOD-PD study). Nephrol Dial Transplant. 2015;30:849–58.
  17. La Porta E, Faragli A, Herrmann A, et al. Bioimpedance analysis in CKD and HF patients: A critical review of benefits, limitations, and future directions. J Clin Med. 2024;13:6502.
  18. Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis—part I: review of principles and methods. Clin Nutr. 2004;23:1226–43.
  19. Scotland G, Cruickshank M, Jacobsen E, et al. Multiple-frequency bioimpedance devices for fluid management in people with chronic kidney disease receiving dialysis: a systematic review and economic evaluation. Health Technol Assess. 2018;22:1-138.
  20. Kim H, Choi GH, Shim KE, et al. Changes in bioimpedance analysis components before and after hemodialysis. Kidney Res Clin Pract. 2018;37:393-403.
  21. Visser WJ, van Ruijven IM, Severs D. Measuring body composition in hemodialysis patients: before or after hemodialysis? Clin Nutr Open Sci. 2023;51:62–6.
  22. Han B-G, Lee JY, Kim J-S, Yang J-W. Decreased bioimpedance phase angle in patients with diabetic chronic kidney disease stage 5. Nutrients. 2019;11:2874.
  23. Low S, Pek SLT, Moh AMC, et al. Association between lower phase angle and chronic kidney disease progression in type 2 diabetes patients. Ann Acad Med Singap. 2023;52:125-34.
  24. Tan R-s, Liang D-h, Liu Y, et al. Bioelectrical impedance analysis–derived phase angle predicts protein–energy wasting in maintenance hemodialysis patients. J Ren Nutr. 2019;29:295–301.
  25. Wang K, Zelnick LR, Chertow GM, et al. Body composition changes following dialysis initiation and cardiovascular and mortality outcomes in CRIC (chronic renal insufficiency cohort): A bioimpedance analysis substudy. Kidney Med. 2021;3:327–34. e321.
  26. Li X, Zhang K, Guo Q, et al. Impedance-derived phase angle as an indicator of physical function in maintenance hemodialysis patients. Nutrition. 2025;136:112795.
  27. Gonzalez MC, Barbosa-Silva TG, Bielemann RM, et al. Phase angle and its determinants in healthy subjects: influence of body composition. Am J Clin Nutr. 2016;103:712-6.
  28. Francisco R, Matias CN, Santos DA, et al. The predictive role of raw bioelectrical impedance parameters in water compartments and fluid distribution assessed by dilution techniques in athletes. Int J Environ Res Public Health. 2020;17:759.
  29. Guo Y, Zhang M, Ye T, et al. Application of bioelectrical impedance analysis in nutritional management of patients with chronic kidney disease. Nutrients. 2023;15:3941.
  30. Wang Y, Gu Z. Effect of bioimpedance-defined overhydration parameters on mortality and cardiovascular events in patients undergoing dialysis: a systematic review and meta-analysis. J Int Med Res. 2021;49:3000605211031063.
  31. Yu S-J, Kim D-h, Oh D-J, et al. Assessment of fluid shifts of body compartments using both bioimpedance analysis and blood volume monitoring. J Korean Med Sci. 2006;21:75-80.