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Total body water measurement in renal insufficiency
M G Bradbury1, J T Brocklebank, S W Smye
1Academic Unit of Paediatrics and Child Health, St. James's University Hospital, Leeds, UK.
Insights
Bioelectrical impedance accurately estimates total body water in children with renal insufficiency. This non-invasive method is superior to skinfold anthropometry for assessing hydration status in pediatric kidney disease.
Area of Science:
- Pediatric Nephrology
- Body Composition Analysis
- Renal Insufficiency
Background:
- Accurate assessment of total body water is crucial for managing children with renal insufficiency.
- Non-invasive methods are preferred for repeated measurements in pediatric populations.
- Deuterium oxide dilution is a gold standard but invasive method for measuring total body water.
Purpose of the Study:
- To compare the accuracy of bioelectrical impedance and skinfold anthropometry with deuterium oxide dilution for measuring total body water in children with renal insufficiency.
- To evaluate the clinical utility of non-invasive methods for body water assessment in this cohort.
Main Methods:
- Total body water was measured in 15 children with glomerular filtration rate < 25 ml/min/1.73 m2 using deuterium oxide dilution.
- Bioelectrical impedance and skinfold anthropometry were used as comparative non-invasive methods.
- Linear correlation and confidence limits were calculated to assess agreement between methods.
Main Results:
- A strong linear correlation (r = 0.98, P < 0.01) was observed between deuterium and height2/impedance.
- Bioelectrical impedance showed narrower 95% confidence limits (-1.5 to 0.9 L) compared to skinfold anthropometry (0.65-3.16 L) against deuterium dilution.
- Bioelectrical impedance demonstrated better agreement with the gold standard method.
Conclusions:
- Bioelectrical impedance is a reliable and more accurate non-invasive method for estimating total body water in children with renal insufficiency compared to skinfold anthropometry.
- This finding supports the use of bioelectrical impedance for monitoring hydration status in pediatric kidney disease.
- Non-invasive bioelectrical impedance offers a practical alternative for assessing body water in children with impaired kidney function.
Abstract:
Total body water was measured in 15 children with renal insufficiency (glomerular filtration rate < 25 ml/min per 1.73 m2) using deuterium oxide dilution. Total body water was also measured using bioelectrical impedance and skinfold anthropometry in the same 15 children. There was a linear correlation (r = 0.98, P < 0.01) between total body water measured by deuterium and height2/impedance. The 95% confidence limits for estimates of total body water were -1.5 to 0.9 for impedance and 0.65-3.16 l for skinfold anthropometry when compared with deuterium dilution. Bioelectrical impedance estimation of total body water is better than the current existing non-invasive method of skinfold anthropometry.