Evaluation of Accuracy of Estimated Ideal Body Weight in Hemodialysis Patients: Comparison of Measured Weight and Blood Pressure Control After Renal Transplantation.

End-stage chronic kidney disease is a growing problem, and the management of dry weight in hemodialysis patients remains a challenge. Clinical assessment for estimating dry weight is the main method used in medical practice. This study aimed to evaluate the accuracy of clinical estimation of dry weight and to investigate associated factors that impact this measurement METHOD: This retrospective study included 74 renal graft recipients from a university hospital between 2020 and 2023, with an estimated glomerular filtration rate ≥ 45 mL/min/1.73 m² at the evaluation time points of 15 or 30 days post-transplantation. Pre-transplant estimated dry weight, post-transplant measured weight, number of antihypertensive medications, and other variables were analyzed

RESULTS

The sensitivity of clinical assessment in estimating pre-transplant dry weight was 62.5% and 75%, and the specificity was 61.9% and 76.2% at 15 and 30 days post-transplantation, respectively. In the sample, 41.9% of the evaluated recipients presented a measured weight one month after transplantation that was lower than the dry weight estimated during dialysis (variation greater than 3%), along with a reduction in the number of antihypertensive medications from 1.58 ± 1.31 to 1.04 ± 1.08

CONCLUSION

Clinical estimation of dry weight demonstrates limited accuracy, highlighting the need for new cost-effective methods to improve volume management in hemodialysis patients.