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Comparing different methods of assessing body composition in end-stage renal failure
1Department of Renal Medicine, Royal North Shore Hospital, University of Sydney, New South Wales, Australia.
Kidney International
|July 8, 2000
Summary
Bioelectrical impedance analysis (BIA) accurately estimates total body water (TBW) and body composition in end-stage renal disease patients. This method offers a reliable alternative to traditional measurements for assessing nutritional status and prognosis.
Area of Science:
- Nephrology
- Nutritional Science
- Biomedical Engineering
Background:
- Accurate nutritional status assessment is crucial for end-stage renal disease (ESRD) patients, impacting prognosis.
- Total body water (TBW) is an independent prognostic marker in ESRD, linked to hypertension and cardiac issues.
Purpose of the Study:
- To evaluate surrogate markers for nutritional status and TBW in ESRD patients.
- To compare different methods for estimating TBW and body composition.
Main Methods:
- Compared deuterium dilution (gold standard) with anthropometric measures (58% body weight, Watson equations) and bioelectrical impedance analysis (BIA) for TBW estimation.
- Assessed fat-free mass (FFM) and total body nitrogen (TBN) using BIA-derived resistance and compared with anthropometric estimates.
Main Results:
- Watson equations and 58% body weight significantly underestimated and overestimated TBW, respectively.
- BIA (Kushner estimation) showed the best agreement with deuterium dilution for TBW, though limits of agreement were large.
- Accurate prediction equations for FFM and TBN were derived using BIA resistance (R2 = 0.95 for FFM, R2 = 0.91 for TBN).
Conclusions:
- TBW estimation methods yield significantly different results in ESRD patients.
- Bioelectrical impedance analysis (BIA) is the most accurate surrogate marker for measuring TBW and body composition parameters in this population.