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제목	Estimation of Body Fluid Volumes by Bioimpedance Spectroscopy in Patients with Hyponatremia can Replace Physical Examination
저자	Jun Young Lee, Jae Seok Kim, Hyeoncheol Park, Jae Won Yang,Byoung Geun Han, Seung Ok Choi
출판정보	2013; 2013(1):
키워드	저나트륨혈증, 생체임피던스, 체수분/Hyponatremia, Bioimpedance spectroscopy, Body fluid
초록	Background: Estimation of body fluid volumes in patients with hyponatremia is useful for diagnosis and therapeutic decision making. Physical examination has been generally used for estimation, but it depends on physician’s abilities. Bioimpedance spectroscopy (BIS) is a reliable method for estimation of body fluid volumes. Therefore, this study was intended to investigate whether BIS could replace the physical examination in patients with hyponatremia. Methods: This study included thirty patients with hyponatremia. At the time of the first visit, body fluid volumes were simultaneously estimated by both physical examination and BIS. In addition, we estimated reversely the body fluid volume that corresponded with most likely cause of hyponatremia (clinical body fluid estimation). Results: The results of body fluid volumes estimated by physical examination showed that the patients with hypervolemia were nine, euvolemia were thirteen, hypovolemia were eight. The results by BIS showed that hypervolemia were ten, euvolemia were fifteen, hypovolemia were five. The results by clinical body fluid estimation showed that hypervolemia were nine, euvolemia were sixteen, hypovolemia were five. Cohen’s kappa analysis conducted for evaluating agreement between two methods showed significant agreement between physical examination and BIS (kappa coefficient 0.632, p=0.000). When comparing each of physical examination and BIS with clinical body fluid estimation, kappa value between physical examination and clinical body fluid estimation was 0.524 (p=0.000), and kappa value between BIS and clinical body fluid estimation was 0.602 (p=0.000). The degree of agreement between BIS and clinical body fluid estimation was higher than the other. Conclusion: BIS can be considered as an alternative method to replace physical examination for estimating body fluid volumes in patients with hyponatremia. In addition, BIS may be more objective and correspond with clinical diagnosis than physical examination.
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