Comparison of multifrequency bioelectrical impedance analysis and dual-energy X-ray absorptiometry assessments in outpatient hemodialysis patients.
BACKGROUND
Malnutrition is common in hemodialysis patients and closely related to increased morbidity and mortality. As such, simple, reliable, and easily available methods of determining nutritional status and recognition of short-term changes in body composition are desirable for routine clinical practice.


METHODS
Diagnostic test study.


METHODS
53 stable adult hemodialysis patients attending for thrice-weekly outpatient hemodialysis in a university tertiary hospital dialysis center.


METHODS
Comparison of dual-energy x-ray absorptiometry (DEXA) and multifrequency bioelectrical impedance analysis (BIA) using a tetrapolar 8-point tactile electrode system as 2 index tests of body composition.


METHODS
None.


RESULTS
Assessment of whole-body composition showed that lean body mass measured using the 2 techniques correlated highly, with good method agreement shown using a Bland-Altman plot (r = 0.92; P < 0.001; bias, +1 g [95% CI, -1,173 to 1,175]), as did fat mass (r = 0.93; P < 0.001; bias, -157 g [95% CI, -1,251 to 937]). Similarly, segmental analysis of lean body mass showed strong correlations between lean body mass of the trunk and right and left legs with small bias (r = 0.85, 0.89, and 0.86, respectively; P < 0.001; Bland-Altman bias, -859, +364, and +552 g, respectively), but weaker correlations for lean body mass for the right and left arm (r = 0.69 and 0.75, respectively; P < 0.001; Bland-Altman bias, -240 and +12 g, respectively). Bone mineral content derived using multifrequency BIA overestimated that measured using DEXA (r = 0.77; P < 0.001; bias, +530 g [95% CI, 422-638]).


CONCLUSIONS
Retrospective study in a healthy ambulant outpatient cohort.


CONCLUSIONS
Compared with DEXA, multifrequency BIA appears to be a robust tool for measuring and monitoring total-body fat and lean body mass in hemodialysis patients; however, there is less agreement in bone mineral content assessment between the 2 methods.
Fürstenberg
Antje
A
Centre for Nephrology, Royal Free Hospital, London, UK.
Davenport
Andrew
A
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000033:anatomy & histology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D001835:Body Weight; D015519:Bone Density; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis; D055815:Young Adult