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Mamat, R., Kong, N. C., Bain, A., Shah, S. A., Caden, R., Wong, V., Mohd, R., Abdul-Gafor, A., & Ismail, R. (2012). Assessment of body fluid status in hemodialysis patients using the body composition monitor measurement technique. Journal of Clinical Nursing,  10(21), 19-23.

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> Additional cost to patients and facilities
> Necessitates that a patient be supine which is hard for some
> Affected by other factors such as medicine and recent food intake

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> Non-invasive and easy to use (only takes 15 minutes total)
> Provides a better alternative to estimating fluid overload
> Measures other nutritional factors such as lean and adipose tissue mass

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BCM uses bioimpedance spectroscopy technique by determining the electrical resistances of the total body water and the extracellular water and enables the separation between extracellular and intracellular water by the extremely wide range of measurement frequencies. Through this BCM is able to separate excess fluid from the lean and adipose tissue components of the body making a body composition model of the patient.

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Fresenius Medical Care introduced the Body Composition Monitor (BCM) as part of the Cardio-protective Hemodialysis Program. This is the first device that determines individual fluid status and body composition in an easy, non-invasive, and objective way. BCM is meant to assist the physicians in the assessment of clinically relevant parameters such as quantification of fluid status and assessment of body composition. Under fluid status, over hydration and total body water are measured. Meanwhile, lean tissue mass and adipose tissue mass are quantified also as part of the body composition making it a good tool for monitoring nutrition. Furthermore, BCM helps to see the link between fluid status and blood pressure making it an appropriate prescription of ultrafiltration and antihypertensive agents.

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Despite advancement in the quality and efficacy of hemodialysis techniques within the last decade, cardiovascular disease remains the leading cause of mortality in dialysis patients. One of the major factor here is fluid overload. Treatment of hypertension and improvement of fluid balance increases life expectancy in this population (Mamat et al., 2012). Thus the need for a more reliable way of testing fluid status in dialysis patients rather than the conventional test-and-see method.