Comparative assessment of hydration status in intestinal failure patients receiving home parenteral nutrition using...

Intestinal failure patients receiving home parenteral nutrition (HPN) are at high risk of dehydration and malnutrition. To optimize clinical care, accurate monitoring tools are required. This study aimed to compare the accuracy of two bioelectrical impedance analysis (BIA) devices, one that offers only BIA results and the other that offers BIA results of bioelectrical impedance vector analysis (BIVA) and bioelectrical impedance spectroscopy (BIS), in assessing hydration and nutritional status in HPN patients.

In a cross-sectional study, 55 adult HPN patients (33 males, 22 females; mean age 61.5 ±13.1 years) underwent BIA measurements using both devices during routine visits. Parameters measured included total body water (TBW), intracellular and extracellular water, fat-free mass, fat mass, and phase angle. Serum urea and creatinine served as hydration markers. Paired t-tests, Mann-Whitney U tests, and Spearman correlations were used for analysis.

The BIA/BIVA/BIS analysis indicated dehydration in 69.1% of patients compared to 29.1% by BIA (p < 0.001) and showed stronger correlations with serum urea. It also classified more patients as malnourished (24.4% vs. 16.4%, p = 0.436). Correlation between hydration status and phase angle was more pronounced when using phase angle determined with BIA/BIVA/BIS.

BIA/BIVA/BIS measurements in the study demonstrated superior sensitivity in detecting dehydration and assessing nutritional status in HPN patients in comparison to BIA, supporting its use for improved clinical monitoring and management in this group of patients.