Differences in bioimpedance-derived fluid status between two versions of the Body Composition Monitor

Abstract

Objectives: The Body Composition Monitor (BCM) (Fresenius Medical Care) measures body impedances in alternating currents to subsequently calculate fat and lean tissue mass, fluid compartments, and overhydration (OH). The aim of this study was to investigate differences between two versions of the BCM (an older version, 3.2.5, and a newer version, 3.3.3).

Methods: Between September 2021 and December 2021, 28 hemodialysis patients were included to undergo BCM measurements before each of 14 consecutive dialysis sessions with versions 3.2.5 and 3.3.3 devices. Measurements were performed according to instructions provided by the manufacturer. Differences between BCM devices were tested for statistical significance using paired Wilcoxon tests, neglecting clustering.

Results: A total of 288 measurement pairs of 27 patients were left after exclusion of 43 flawed data points. The mean difference in OH between both BCM devices was 0.548 L (higher for version 3.2.5). Analysis of impedance data revealed differences in the high-frequency spectrum, quantifiable by the intracellular resistance, R_i (median R_{i version 3.2.5} = 1750.3 Ω; R_{i version 3.3.3} = 1612.45 Ω; P < 0.001), and the time delay, T_d (median T_{d version 3.2.5} = 1.85 ns; T_{d version 3.3.3} = 8.88 nanoseconds; P < 0.001).

Conclusions: This study finds that results between the two versions of the BCM differed in a clinically meaningful fashion and that the newer version 3.3.3 device had a bias toward less OH. Circulating BCM devices should be checked for versions and only devices of the same version should be used for each patient to ensure better within-patient consistency.

Keywords: Bioimpedance; Body Composition Monitor; Chronic hemodialysis; Fluid status; Target weight.