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Fluid management for hemodialysis

Effective cardioprotection

  • Reduced mortality1
  • Reduction of intradialytic hypotensive episodes2
  • Cost-saving potential

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 patients3. The BCM-Body Composition Monitor is the core component of the Advanced Fluid Management therapy programme 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.

Advanced 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

Cost-saving potential of fluid management

In dialysis patients, fluid overload is associated with acute complications including congestive heart failure and pulmonary oedema. Fluid overload can require emergency dialysis outside of the routine dialysis sessions. These additional treatments are common and expensive. In an US investigation, the total cost in the study period of two years was approximately $266 million4.

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

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.

BCM — Body Composition Monitor

Quantifying fluid status for more confidence in Fluid Management 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

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). 

  

Guiding the hemodialysis patient on the safe path between volume overload and dehydration can be difficult in daily clinical practice.

  • Assessment of fluid status based on subjective indicators has been a limiting factor due to the lack of objectiveness
  • Several other methods that have been proposed are often unavailable, expensive or difficult to handle
  • Most importantly, they are unable to quantify fluid overload or deficiency


The BCM-Body Composition Monitor is the only body composition device specifically designed for the use in patients with ESRD and is the cornerstone of the Advanced Fluid Management therapy program of Fresenius Medical Care. It measures and quantifies key fluid and nutritional parameters and provides a reliable decision basis for fluid and nutritional management of dialysis patients.

The BCM-Body Composition Monitor measures noninvasively, fast and cost-effectively at the bedside.

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1 Wizemann V. et al., Nephrology Dialysis Transplantation (2009); 24: 1574-1579.

2 Machek P. et al., Nephrology Dialysis Transplantation (2010); 25: 538-544.

3 Arneson T. et al., Clinical Journal of the American Society of Nephrology (2010); 5: 1054-1063.

4 Arneson T. et al., Clinical Journal of the American Society of Nephrology (2010); 5: 1054-1063.