Effects of treatment on extracellular fluid changes in the lower extremities of patients with chronic venous insufficiency using bioelectrical impedance analysis

The Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification to describe patients with chronic venous disease (CVD) has limitations in that it cannot be quantitatively evaluated. Thus, we aimed to determine whether measuring changes in extracellular fluid (ECF) can be an objective and quantitative indicator after CVD treatment. In this retrospective, single-center study, changes in ECF and symptoms of CVD were analyzed using bioelectrical impedance analysis at baseline (V0), after 1 month (V1), and after 3 months (V2) between April and November 2023. Subgroup analysis was performed to determine whether sex, body mass index (BMI), baseline CEAP grade, and additional diuretic use could affect further ECF reduction. Compared with V0, ECF in both legs significantly reduced over the intervention period. At V1, compared with V0, significant ECF reduction in the right leg (-0.47%, P = .0085) and left leg (-0.57% and P = .0021) were observed. ECF reduction at V2 was more pronounced compared to 1 month after treatment in the right leg (-0.66%, P = .001) and left leg (-0.71% and P = .0003). Sex, baseline CEAP grade, and additional diuretic use did not affect the difference in the decline of ECF after treatment, but BMI caused significant differences in the degree of ECF reduction after treatment. Changes in ECF evaluated by bioelectrical impedance analysis can be an objective indicator of the treatment effect of chronic venous insufficiency. Diuretic combination with a venoactive drug did not bring additional benefits. The decrease in ECF after CVD treatment was more pronounced in patients with BMI < 23.