Velena Popovic1, Bo Zerahn2, James Goya Heaf3. 1. Department of Nephrology, Herlev Hospital, University of Copenhagen, Herlev, Denmark. Electronic address: velena@gmail.com. 2. Department of Clinical Physiology, Herlev Hospital, University of Copenhagen, Herlev, Denmark. 3. Department of Medicine, Roskilde Hospital, University of Copenhagen, Herlev and Roskilde, Denmark.
Abstract
OBJECTIVE: Peritoneal dialysis (PD) patients are characterized by protein malnutrition and muscle wasting. Reliable, easy, and cheap methods for evaluating nutrition are desirable. Three methods are commonly available: dual-energy X-ray absorptiometry (DXA), bioimpedance (BI), and subjective global assessment (SGA).The objective of the study was to compare the previously mentioned methods for assessment of body composition and nutritional status in PD patients. DESIGN: The study is cross-sectional and consisted of 72 PD patients from a single center PD ambulatorium. METHODS: Participants were measured twice by DXA, twice by BI, and once by SGA. Measurements included lean tissue mass (LTM), fat tissue mass (FT) and, for BI, overhydration (OH), intracellular water (ICW), and extracellular water (ECW). LTM and FT were indexed to body area (Lean Tissue Index [LTI] and Fat Tissue Index [FTI], respectively), and ICW for height (ICW/ht). We assessed conventional biochemical and clinical variables, using values for normal individuals as a reference. RESULTS: There was good overall agreement between BI and DXA but considerable intra-individual variation (1 standard deviation: FT 5.7 kg; LTM 5.6 kg). Factors affecting the differences were FT, ICW, LTM, and ICW. Obesity (DXA 43%; BI 54%) and muscle wasting (BI 28%; SGA 53%) were common. Agreement between BI and SGA was poor. Thirty-eight percent of patients judged malnourished by SGA also had a low LTI; 23% with normal SGA had low LTI. SGA was closer related to LTI (BI) than LTI (DXA). Plasma albumin was correlated to LTI, FTI, and ICW/ht, and comorbidity to OH, clinical malnutrition, reduced FTI, but not LTI. CONCLUSION: Agreement between DXA and BI was high on a population basis but not at an individual level. Obesity and muscle wasting were common in this population. OH might reduce DXA accuracy in PD patients. LTI and ICW may be useful measures to supplement SGA in assessing nutrition.
OBJECTIVE: Peritoneal dialysis (PD) patients are characterized by protein malnutrition and muscle wasting. Reliable, easy, and cheap methods for evaluating nutrition are desirable. Three methods are commonly available: dual-energy X-ray absorptiometry (DXA), bioimpedance (BI), and subjective global assessment (SGA).The objective of the study was to compare the previously mentioned methods for assessment of body composition and nutritional status in PDpatients. DESIGN: The study is cross-sectional and consisted of 72 PDpatients from a single center PD ambulatorium. METHODS:Participants were measured twice by DXA, twice by BI, and once by SGA. Measurements included lean tissue mass (LTM), fat tissue mass (FT) and, for BI, overhydration (OH), intracellular water (ICW), and extracellular water (ECW). LTM and FT were indexed to body area (Lean Tissue Index [LTI] and Fat Tissue Index [FTI], respectively), and ICW for height (ICW/ht). We assessed conventional biochemical and clinical variables, using values for normal individuals as a reference. RESULTS: There was good overall agreement between BI and DXA but considerable intra-individual variation (1 standard deviation: FT 5.7 kg; LTM 5.6 kg). Factors affecting the differences were FT, ICW, LTM, and ICW. Obesity (DXA 43%; BI 54%) and muscle wasting (BI 28%; SGA 53%) were common. Agreement between BI and SGA was poor. Thirty-eight percent of patients judged malnourished by SGA also had a low LTI; 23% with normal SGA had low LTI. SGA was closer related to LTI (BI) than LTI (DXA). Plasma albumin was correlated to LTI, FTI, and ICW/ht, and comorbidity to OH, clinical malnutrition, reduced FTI, but not LTI. CONCLUSION: Agreement between DXA and BI was high on a population basis but not at an individual level. Obesity and muscle wasting were common in this population. OH might reduce DXA accuracy in PDpatients. LTI and ICW may be useful measures to supplement SGA in assessing nutrition.
Authors: Eline Vermeiren; Marijke Ysebaert; Kim Van Hoorenbeeck; Luc Bruyndonckx; Kristof Van Dessel; Maria Van Helvoirt; Ann De Guchtenaere; Benedicte De Winter; Stijn Verhulst; Annelies Van Eyck Journal: Eur J Clin Nutr Date: 2020-09-11 Impact factor: 4.016
Authors: Natália T Bellafronte; Marina R Batistuti; Nathália Z Dos Santos; Héric Holland; Elen A Romão; Paula G Chiarello Journal: J Electr Bioimpedance Date: 2018-12-31
Authors: Christian Verger; Claudio Ronco; Wim Van Biesen; James Heaf; François Vrtovsnik; Manel Vera Rivera; Ilze Puide; Raymond Azar; Adelheid Gauly; Saynab Atiye; Tatiana De Los Ríos Journal: Front Med (Lausanne) Date: 2021-12-24
Authors: Natascha J H Broers; Bernard Canaud; Marijke J E Dekker; Frank M van der Sande; Stefano Stuard; Peter Wabel; Jeroen P Kooman Journal: Hemodial Int Date: 2020-01-22 Impact factor: 1.812