Study Comparing Dryweight Determination in Hemodialysis Patients With Two Methods

All patients in the study will undergo a period of prior randomization of a week, where data will be registered such as pre and post blood pressure, average weight gain (delta weight) between sessions and transdialysis complications. In the first phase, BIA and clinical evaluation to assess blood volume pre-hemodialysis session state in a single assessment will evaluate all patients in the study. The clinical assessment method of dry weight determination includes: patient history in search of signs and symptoms of volume overload, analysis of pre treatment blood pressure, adventitious sounds in pulmonary auscultation among others. Patients will be randomized in a systematic manner into two groups: Group A - Clinic Assessment (AC): patients will have dry weight determine by clinical examination, as unit routine, for four weeks. Clinical criteria for dry weight adjustments are: edema, dyspnea, reported shortness of breath, post dialysis blood pressure greater than or equal 140/90 mmHg. Group B - bioimpedance (BIA): BIA was used to estimate dry weight for four weeks, pre first HD session of the week. At the end of the first four weeks both groups will be assessed for hydration state, data registered in specific instrument to assess weight gain between sessions, frequency of complications and time to reach dry weight. After two weeks' interval, wash out, groups would change the method used to assess their dry weight. ( A - BIA and B -CA) After the second phase, all patients had a further evaluation with BIA to assess for hydration state, weight gain between sessions, frequency of complications and time to reach dry weight, all data registered in a specific instrument. Dry weight was achieved by adjustments made in all HD sessions, based on clinical evaluation or BIA. The maximum decrement to achieved dry weight was 500 grams of weight per dialysis session. Nurses did clinical evaluation in both groups. The unit heath team, nurses and doctors, trained in the methodology used in the research helped determine dry weight.