Multiple frequency bioimpedance devices for fluid management in people with chronic kidney disease having dialysis

Summary

Chronic kidney disease (CKD) is a long-term condition that often requires dialysis treatment. During dialysis, it is important to optimise the volume of fluid to be removed, to avoid underhydration or overhydration. People having dialysis are, therefore, assigned a ‘target weight’, which is commonly assessed using clinical methods such as weight gain between dialysis sessions, pre- and post-dialysis blood pressure and patient-reported symptoms. These methods, however, are not precise and measurement using bioimpedance devices is becoming common practice. This NIHR HTA-funded evidence synthesis assessed the clinical and cost-effectiveness of multiple frequency bioimpedance devices for fluid management in people with chronic kidney disease having dialysis. The devices being considered as an alternative to standard clinical assessment in the UK were: BCM - Body Composition Monitor, BioScan 920-II, BioScan touch i8, InBody S10, and MultiScan 5000. The assessment was conducted according to current methodological standards and a de novo economic model was developed to assess the cost-effectiveness of use of the specified devices versus standard clinical assessment. The current NICE guidance (DG29, published June 2017), which is based upon the findings of this assessment, states that there is insufficient evidence to recommend the adoption of the BCM – Body Composition Monitor to guide fluid management in people with chronic disease having dialysis in the NHS. Further evidence is recommended to show the evidence of using the BCM – Body Composition Monitor on outcomes.

http://www.nice/.org.uk/guidance/dg29

http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016041785

Contact

Miriam Brazzelli; m.brazzelli@abdn.ac.uk

Status

Completed

Publications

Scotland, G, Cruickshank, M, Jacobsen, E, Cooper, D, Fraser, C, Shimonovich, M, Marks, A, Brazzelli, M  Multiple frequency bioimpedance devices for fluid management in people with chronic kidney disease having dialysis: A systematic review and economic evaluation. Health Technol Assess 2017 (accepted for publication)