[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-453152-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-453152-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","regarding-the-efficacy-and-safety-of-technology-guided-dry-weight-adjustment-among-dialysis-patients-letter-to-the-editor","Regarding The Efficacy and Safety of Technology-Guided Dry Weight Adjustment Among Dialysis Patients - Letter to the Editor","","Letter to the editor addressing a meta-analysis by Wathanavasin et al on technology-guided dry weight adjustment in dialysis patients. The letter discusses the clinical need to achieve euvolemia objectively and repeatably, critiques potential number transposition in reported death and cardiovascular event counts, and estimates modest absolute benefits. Citing limitations such as average short follow-up duration, the authors recommend continued clinical probing for dry weight guided by symptoms, physical examination, and blood pressure.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/regarding-the-efficacy-and-safety-of-technology-guided-dry-weight-adjustment-among-dialysis-patients-letter-to-the-editor/453152/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/regarding-the-efficacy-and-safety-of-technology-guided-dry-weight-adjustment-among-dialysis-patients-letter-to-the-editor/453152.png","ImageObject",300,407,{"name":42,"@type":43},"Olivia Brown","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What clinical problem does the letter focus on in dialysis patients?","Question",{"text":62,"@type":63},"It focuses on volume overload worsening morbidity and mortality and the importance of achieving euvolemia in dialysis patients.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How does the letter interpret the reported trial results for deaths and cardiovascular events?",{"text":67,"@type":63},"It suggests the differences shown in the paper’s table may be due to a typographical transposition of numbers, leading to small absolute mortality and cardiovascular event benefits.",{"name":69,"@type":60,"acceptedAnswer":70},"What is the recommended approach pending longer studies?",{"text":71,"@type":63},"The letter advises that clinical probing for dry weight remains standard of care, guided by symptoms, physical examination, and blood pressure, until longer-duration technology-guided trials are available.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},453152,1790978113,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":30,"preview_page_count":4},16904993612988,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Correspondence  \nLETTER TO THE EDITOR  \nRegarding “The Efficacy and Safety of Technology-Guided Dry Weight Adjustment Among Dialysis Patients: A Meta-Analysis of Randomized Controlled Trials” by Wathanavasin et al  \nTo the Editor,  \nWe read with interest the comprehensive review in Kidney Medicine by Whathanavasin et al1 on the multiple technologies used for adjustment of extracellular volume in dialysis patients. Volume overload worsens morbidity and mortality of patients receiving dialysis, hence the importance of achieving euvolemia. Clinical approaches such as probing for the dry weight can significantly attenuate cardiovascular morbidity and mortality2 but they are subjective. Getting to euvolemia needs objective, practical, and repeatable methods.3 These also must genuinely reduce morbidity and mortality. Table 2 of the paper by Whathanavasin et al1 shows that 13 studies of such techniques yielded a combined higher number of deaths in the intervention groups (1,741 patients compared with 1,707), and more cardiovascular events in 9 studies (1,090 compared with 1,065) . This difference may be a typographical transposition of the numbers. If so, then the absolute mortality benefit of the technology would be 34/ 1,741, a 2% benefit, and the cardiovascular event benefit 35/ 1,065, which is a 3% benefit. These benefits are modest, which is perhaps partly attributable to the relatively short follow-up times of the reviewed studies shown in Table 1, which averaged only 14 months.1 Pending longer-duration studies from well-designed trials of technological guidance, such as bioimpedance, we advise that clinical probing for dry weight remains the standard of care in the management of patients receiving hemodialysis, that is, the achievement of  \neuvolemia as guided by symptoms, physical examination, and blood pressure.2  \nEric P. Cohen, MD, and Bernard Canaud, MD  \nARTICLE INFORMATION  \nAuthors’ Affiliations: New York University School of Medicine, New York, New York (EPC); and Universit de Montpellier, Montpellier, France (BC) .  \nAddress for Correspondence: Eric P. Cohen, MD, New York University School of Medicine, New York, New York. Email: eric. [cohen@nyulangone.org](cohen@nyulangone.org)  \nSupport: None.  \nFinancial Disclosure: Bernard Canaud is Emeritus Medical Officer, Global Medical Office, Fresenius Medical Care Deutschland, Bad Homburg, Germany, and CEO of MTX Consulting Int. Montpellier, France. Eric P. Cohen declares that he has no relevant financial interests.  \nPeer Review: Received August 20, 2025. Evaluated by the Editorin-Chief. Accepted September 4, 2025.  \nPublication Information: Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is a US Government Work. There are no restrictions on its use. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/](http://creativecommons.org/licenses/by/)[ ](http://creativecommons.org/licenses/by/)[4.0/](4.0/)) . Published online December 9, 2025 with doi 10. 1016/ j.xkme.2025.101204  \nREFERENCES  \n1. Wathanavasin W, Thongprayoon C, Davis PW, Cheungpasitporn W. The efficacy and safety of technologyguided dry weight adjustment among dialysis patients: a meta-analysis of randomized controlled trials. Kidney Med. 2025;7(8):101052 .  \n2. Charra B, Calemard E, Ruffet M, et al. Survival as an index of adequacy of dialysis. Kidney Int. 1992;41(5):1286-1291 .  \n3. Hecking M, Madero M, Port FK, Schneditz D, Wabel P, Chazot C. Fluid volume management in hemodialysis: never give up. Kidney Int. 2023;103(1):2-5 .  \nKidney Med Vol 8 | Iss 1 | January 2026 | 101204 1","cbCaisfDFW7ry4xn","https://ap.wps.com/l/cbCaisfDFW7ry4xn","pdf",1449127,"English","# Correspondence\n## Letter to the Editor\n## Article Information\n## References","[{\"question\":\"What clinical problem does the letter focus on in dialysis patients?\",\"answer\":\"It focuses on volume overload worsening morbidity and mortality and the importance of achieving euvolemia in dialysis patients.\"},{\"question\":\"How does the letter interpret the reported trial results for deaths and cardiovascular events?\",\"answer\":\"It suggests the differences shown in the paper’s table may be due to a typographical transposition of numbers, leading to small absolute mortality and cardiovascular event benefits.\"},{\"question\":\"What is the recommended approach pending longer studies?\",\"answer\":\"The letter advises that clinical probing for dry weight remains standard of care, guided by symptoms, physical examination, and blood pressure, until longer-duration technology-guided trials are available.\"}]","Regarding The Efficacy and Safety of Technology-Guided Dry Weight Adjustment Among Dialysis Patients - Letter to the Editor | PDF",1790738357]