Rajeevalochana Parthasarathy1, Elizabeth Oei1, Stanley L Fan2. 1. Departments of Renal Medicine and Transplantation, Barts Health NHS Trust, London, E1 1BB, UK. 2. Departments of Renal Medicine and Transplantation, Barts Health NHS Trust, London, E1 1BB, UK. fan.stanley@bartshealth.nhs.uk.
Abstract
BACKGROUND/ OBJECTIVES: Bioimpedance analysis is often routinely performed in any dialysis unit to guide fluid management but can provide a reproduceable assessment of fat and muscle mass. We wished to determine the clinical significance of low muscle or high fat mass and the determinants that influence their change. SUBJECTS/ METHODS: We performed retrospective analysis of 824 patients on peritoneal dialysis who underwent routine repeated bioimpedance analysis measurements using the body composition monitor (BCM). RESULTS: Lean tissue index (LTI) was an independent predictor of mortality when sex, age, PD vintage and diabetes status were included in the models (HR 0.93; 95% CI 0.86-1.00, p < 0.05) and when baseline serum albumin was included in a separate model (HR 0.86; 95% CI: 0.79-0.93, p < 0.001). High fat tissue index (FTI) was an independent predictor of mortality when demographic factors were included (HR 0.87; 95% CI: 0.78-0.97, p < 0.02), but not with the addition biochemical parameters. Changes in body composition of 206 patients over a 2-year follow-up period could not be predicted by baseline demographics, functional or biochemical assessments. However, there was a strong inverse relationship between changes in LTI and FTI. There were no associations between changes in body composition with prescribed dialysate glucose. CONCLUSIONS: We showed body composition changes are common and complex. LTI was an independent predictor of survival. Changes in LTI and FTI could not be predicted by baseline parameters. BCM may be a sensitive and accurate tool to monitor changes in body composition during dialysis treatment.
BACKGROUND/ OBJECTIVES: Bioimpedance analysis is often routinely performed in any dialysis unit to guide fluid management but can provide a reproduceable assessment of fat and muscle mass. We wished to determine the clinical significance of low muscle or high fat mass and the determinants that influence their change. SUBJECTS/ METHODS: We performed retrospective analysis of 824 patients on peritoneal dialysis who underwent routine repeated bioimpedance analysis measurements using the body composition monitor (BCM). RESULTS: Lean tissue index (LTI) was an independent predictor of mortality when sex, age, PD vintage and diabetes status were included in the models (HR 0.93; 95% CI 0.86-1.00, p < 0.05) and when baseline serum albumin was included in a separate model (HR 0.86; 95% CI: 0.79-0.93, p < 0.001). High fat tissue index (FTI) was an independent predictor of mortality when demographic factors were included (HR 0.87; 95% CI: 0.78-0.97, p < 0.02), but not with the addition biochemical parameters. Changes in body composition of 206 patients over a 2-year follow-up period could not be predicted by baseline demographics, functional or biochemical assessments. However, there was a strong inverse relationship between changes in LTI and FTI. There were no associations between changes in body composition with prescribed dialysate glucose. CONCLUSIONS: We showed body composition changes are common and complex. LTI was an independent predictor of survival. Changes in LTI and FTI could not be predicted by baseline parameters. BCM may be a sensitive and accurate tool to monitor changes in body composition during dialysis treatment.
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