Background: Idiopathic edema (IE) is a common clinical syndrome. Designing treatment plans for IE is problematic because of the difficulty in assessing volume status. We aimed to evaluate volume status, measured by bioimpedance spectroscopy (BIS), and investigated clinical parameters associated with volume overload (VO) in patients with IE. Methods: Patients with IE were defined as those with symptomatic edema and without abnormal renal function or any other apparent cause of edema. A total of 124 patients were included. Overhydration (OH) and extracellular water (ECW) were calculated using BIS. Relative hydration status (ΔHS) was defined as OH/ECW. Patients were classified into 2 groups: overhydrated group (OG; ΔHS ≥7%) and non-OG (NOG; ΔHS <7). Simple and multiple logistic regression analyses were used to assess the influence of several variables on the incidence of VO. Results: Of 124 patients, 37 (29.8%) were in the OG. The proportion of men in the OG was higher than that in the NOG (p = 0.020). Patients in the OG showed more frequent pretibial pitting edema (PTPE, p < 0.001) and had lower hemoglobin (p = 0.008) and serum albumin levels (p < 0.001). The multivariate analysis showed that the presence of PTPE (OR 10.62, 95% CI 1.98-57.1), low serum albumin level (OR 0.01, 95% CI 0.00-0.25) and lower fat tissue index (OR 0.78, 95% CI 0.63-0.97) were independent risk factors for the presence of VO. Conclusions: BIS helps to identify volume status and body composition in patients with IE.

Kay A, Davis CL: Idiopathic edema. Am J Kidney Dis 1999;34:405-423.
Edwards OM, Bayliss RI: Idiopathic oedema of women. A clinical and investigative study. Q J Med 1976;45:125-144.
Hill SR Jr, Hood WG Jr, Farmer TA Jr, Burnum JF: Report of a case with orthostatic edema and hyperaldosteronism. N Engl J Med 1960;263:1342-1345.
Mees EJD: Idiopathic edema: definition of the syndrome and an approach to management. Nephrol Dial Transplant 1994;9(supp):3-9.
de Wardener HE: Idiopathic edema: role of diuretic abuse. Kidney Int 1981;19:881-891.
Streeten DH: The role of posture in idiopathic oedema. S Afr Med J 1975;49:462-464.
Feely J: The many faces of idiopathic oedema of women. Postgrad Med J 1982;58:229-232.
Hung SC, Kuo KL, Peng CH, Wu CH, Lien YC, Wang YC, et al: Volume overload correlates with cardiovascular risk factors in patients with chronic kidney disease. Kidney Int 2014;85:703-709.
Raimann JG, Zhu F, Wang J, Thijssen S, Kuhlmann MK, Kotanko P, et al: Comparison of fluid volume estimates in chronic hemodialysis patients by bioimpedance, direct isotopic, and dilution methods. Kidney Int 2014;85:898-908.
Woodrow G: Body composition analysis techniques in adult and pediatric patients: how reliable are they? How useful are they clinically? Perit Dial Int 2007;27(suppl 2):S245-S249.
Chamney PW, Wabel P, Moissl UM, Müller MJ, Bosy-Westphal A, Korth O, et al: A whole-body model to distinguish excess fluid from the hydration of major body tissues. Am J Clin Nutr 2007;85:80-89.
Moissl UM, Wabel P, Chamney PW, Bosaeus I, Levin NW, Bosy-Westphal A, et al: Body fluid volume determination via body composition spectroscopy in health and disease. Physiol Meas 2006;27:921-933.
Wabel P, Chamney P, Moissl U, Jirka T: Importance of whole-body bioimpedance spectroscopy for the management of fluid balance. Blood Purif 2009;27:75-80.
O'Lone EL, Visser A, Finney H, Fan SL: Clinical significance of multi-frequency bioimpedance spectroscopy in peritoneal dialysis patients: independent predictor of patient survival. Nephrol Dial Transplant 2014;29:1430-1437.
Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C, et al: The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant 2009;24:1574-1579.
Van Biesen W, Williams JD, Covic AC, Fan S, Claes K, Lichodziejewska-Niemierko M, et al: Fluid status in peritoneal dialysis patients: the European body composition monitoring (EuroBCM) study cohort. PLoS One 2011;6:e17148.
Gatta A, Verardo A, Bolognesi M: Hypoalbuminemia. Intern Emerg Med 2012;7(suppl 3):S193-S199.
Gill JR Jr, Waldmann TA, Bartter FC: Idiopathic edema. I. The occurrence of hypoalbuminemia and abnormal albumin metabolism in women with unexplained edema. Am J Med 1972;52:444-451.
Gill JR Jr, Cox J, Delea CS, Bartter FC: Idiopathic edema. II. Pathogenesis of edema in patients with hypoalbuminemia. Am J Med 1972;52:452-456.
Antlanger M, Hecking M, Haidinger M, Werzowa J, Kovarik JJ, Paul G, et al: Fluid overload in hemodialysis patients: a cross-sectional study to determine its association with cardiac biomarkers and nutritional status. BMC Nephrol 2013;14:266.
Levin A, Thompson CR, Ethier J, Carlisle EJ, Tobe S, Mendelssohn D, et al: Left ventricular mass index increase in early renal disease: impact of decline in hemoglobin. Am J Kidney Dis 1999;34:125-134.
Sanderson JE: Pathogenesis of oedema in chronic severe anaemia: studies of body water and sodium, renal function, haemodynamic variables and plasma hormones. Br Heart J 1994;71:490.
Seppel T, Kosel A, Schlaghecke R: Bioelectrical impedance assessment of body composition in thyroid disease. Eur J Endocrinol 1997;136:493-498.
De Lorenzo A, Andreoli A, Fusco A, Magnani A, D'Orazio N, Bertoli A: Effect of subclinical hypothyroidism on body fluid compartments. Horm Metab Res 2000;32:359-363.
WHO Expert Consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-163.
Kazory A, Klein A, Chalopin JM, Ducloux D, Courivaud C: Obesity and atherosclerotic events in chronic hemodialysis patients: a prospective study. Nephrol Dial Transplant 2013;28(suppl 4):iv188-iv194.
Prado CM, Gonzalez MC, Heymsfield SB: Body composition phenotypes and obesity paradox. Curr Opin Clin Nutr Metab Care 2015;18:535-551.
Weinberger I, Fuchs J, Rotenberg Z, Erdberg A, Agmon J: Idiopathic edema in a male. Am J Med Sci 1984;288:27-31.
Denning DW, Dunnigan MG, Tillman J, Davis JA, Forrest CA: The relationship between ‘normal' fluid retention in women and idiopathic oedema. Postgrad Med J 1990;66:363-366.
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