title: Long-term evaluation of nutritional status using dual-energy X-ray absorptiometry in chronic hemodialysis patients.
abstract: BACKGROUND
  Hemodialysis patients very often suffer from malnutrition with net loss of body muscle and fat stores. Since protein-calorie malnutrition has been considered to be highly associated with increased morbidity and mortality, it is important that the nutritional status is evaluated accurately and that long-term evaluation of the nutritional status is performed to obtain good outcome.
  
  
  METHODS
  Forty-six patients (28 men and 18 women) undergoing maintenance hemodialysis were studied. Nutritional status of the patients was examined by dual-energy X-ray absorptiometry (DXA) and anthropometry measurements after a hemodialysis session and 4 years after the initial measurement.
  
  
  RESULTS
  Percent fat, the ratio of body fat (BF) to weight, determined by DXA correlated positively with body mass index (BMI) calculated from weight and height. There was also a significant positive correlation between lean body mass (LBM) determined by DXA and arm muscle circumference (AMC) calculated using the anthropometric method. In the study period of 4 years, LBM and bone mineral content (BMC) observed at the end point were significantly lower than those at the start. In contrast, BF and %fat at the end point were significantly higher as compared with those at the initial measurement.
  
  
  CONCLUSIONS
  These results indicate that DXA is a reliable method for body composition analysis in chronic hemodialysis patients. Because the detection of early alterations in body composition may provide an early indication of the development of malnutrition, serial evaluation of body composition using DXA should be valid for assessment of the nutritional status.
authors.affiliation: Second Department of Medicine, Kagawa Medical University, Kita-gun, Kagawa, Japan. ntaka@kms.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Yuasa
authors.forename: M
authors.initials: M
authors.lastname: Fukunaga
authors.forename: T
authors.initials: T
authors.lastname: Hara
authors.forename: K
authors.initials: K
authors.lastname: Moriwaki
authors.forename: T
authors.initials: T
authors.lastname: Shokoji
authors.forename: H
authors.initials: H
authors.lastname: Hitomi
authors.forename: H
authors.initials: H
authors.lastname: Fujioka
authors.forename: H
authors.initials: H
authors.lastname: Kiyomoto
authors.forename: Y
authors.initials: Y
authors.lastname: Aki
authors.forename: M
authors.initials: M
authors.lastname: Hirohata
authors.forename: K
authors.initials: K
authors.lastname: Mizushige
authors.forename: M
authors.initials: M
authors.lastname: Kohno
mesh_terms: D015502:Absorptiometry, Photon; D001823:Body Composition; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis; D012307:Risk Factors