Fluid management for hemodialysis

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Fresenius Medical Care, together with healthcare professionals worldwide, is dedicated to reducing the high cardiovascular morbidity and mortality of ESRD patients. Achieving optimal fluid balance is therefore one of the central challenges in routine clinical practice.

Specifically designed for ESRD patients, the BCM, Body Composition Monitor, provides an objective measurement of overhydration. This opens the door for both reproducible and reliable assessment of fluid as well as nutrition status. The BCM can be an invaluable tool towards improved fluid management that enable ESRD patients to enjoy every important moment in their lives.

In addition to the BCM, the accompanying Fluid Management Tool (FMT)* software delivers valuable trend analysis information, providing important feedback and guidance on therapy decisions. Together with the BCM, the FMT provides the clinician with relevant information to manage the fluid nutrition status of dialysis patients.

*purchase separately

Advanced fluid management for effective cardioprotection

Chronic volume overload is a common condition among patients with ESRD and is directly associated with hypertension, increased arterial stiffness and left ventricular hypertrophy (LVH). It is ultimately one of the key factors contributing to the high CVD related morbidity and mortality amongst these patients. Vice versa, it was demonstrated that achieving normohydration through effective Fluid Management therapy is associated with better outcome of HD patients¹. The BCM-Body Composition Monitor is the core component of the Fluid Management therapy program of Fresenius Medical Care. It measures and quantifies the patient’s fluid status and provides a reliable decision basis for effective fluid and nutritional management.

The BCM-Body Composition Monitor is a basic part of the CorDiax product line.

Fluid management may lead to:
Improved patient well-being
Less intradialytic complications and hypotensive episodes
Better control of hypertension
Reduction in antihypertensive medication Reduced cardiovascular mortality

Significant Observations from Physicians Using the BCM

The BCM, utilizing advanced bioimpedance technology, has been shown to be an important tool in helping to provide both objective and reliable information needed in determination of dry weight. This has the potential to help in limiting the repetitive cycle involved in the probing process and, thus possibly reduce chances of hypotensive events that may lead to cardiovascular issues.

“No heart attacks were observed and no emergency dialysis occurred, and the number of intra-dialytic complications such as hypotension were reduced with the assistance of the BCM in the assessment of fluid status in a group of HD patients².”

“Volume control guided by objective assessment of fluid overload (with the BCM) showed significant decrease in left ventricular mass and improved BP control³.”

“Assessment of fluid overload with bioimpedance spectroscopy (BCM) provides better management of fluid status, which leads to significant improvement in the cardiovascular status of HD patients – Hur, et al³.”

BCM-Body Composition Monitor

From technology to therapy

Body weight and BMI (Body Mass Index) do not differentiate between muscle, fat and water. In addition, body composition is often described in terms of fat free mass (FFM) and fat mass (Fat) only, not considering over-hydration.

The BCM – Body Composition Monitor is the first device on the market to distinguish the muscle mass from pathologic fluid overload. This is of special interest for detecting malnutrition in chronic kidney disease patients. The BCM - Body Composition Monitor separates excess fluid (over-hydration) from the lean and adipose tissue components of the body on the basis of a unique body composition model.

Learn more about the Body Composition Monitor

BCM — Body Composition Monitor

The BCM – Body Composition Monitor The Body Composition Monitor is the first device on the market to distinguish the muscle mass from pathologic fluid overload. This is of special interest for detecting malnutrition in chronic kidney disease patients.

The three compartments

Body weight = Lean Tissue Mass + Adipose Tissue Mass + Over-hydration The three compartments (LTM, ATM and OH) are identified from measurements of body weight, height, intracellular (ICW) and extracellular water (ECW) determined by whole body bioimpedance spectroscopy (BIS).

¹ Wizemann V. et al., Nephrology Dialysis Transplantation (2009); 24: 1574-1579
² Machek P, et al, 2008 Optimal Fluid Status Assessed with Bioimpedance Spectroscopy Reduces IMES and Hospitalization in Hemodialysis Patients, XLV-ERA-EDTA-Congress Poster MP 266
³ Hur E, et al, 2013 Effect of Fluid Management Guided by Bioimpedance Spectroscopy on Cardiovascular Parameters in Hemodialysis Patients: A Randomized Controlled Trail, Am J Kidney Dis; 61: 957-965.
⁴ Arneson T. et al., Clinical Journal of the American Society of Nephrology (2010); 5: 1054-1063.

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Effective cardioprotection

*purchase separately

Advanced fluid management for effective cardioprotection

Significant Observations from Physicians Using the BCM

Cost-saving potential of fluid management