title: Longitudinal body composition changes due to dialysis.
abstract: OBJECTIVE
  Nutritional status remains a powerful predictor of outcome in the dialysis population. High body mass index (BMI) seems protective, but which body compartment (fat or lean mass) confers this protection remains unclear.
  
  
  METHODS
  This was a longitudinal study (n = 60; n = 46 completed) examining changes in body composition in incident peritoneal dialysis (PD) and hemodialysis (HD) patients over 12 months. We measured total body protein (TBP) by in vivo neutron activation, expressed as nitrogen index (NI), and lean body mass (LBM) and total body fat (TBF) by dual-energy x-ray absorptiometry. Visceral and subcutaneous fat areas (SFAs) were determined from computed tomography. Comparisons were made between different BMI groups and dialysis modalities.
  
  
  RESULTS
  No significant change was found in TBP, NI, or TBF. The obese group (BMI >30) had an increase in all mean LBM parameters with a significant increase in NI compared with normal-weight and the overweight group. This increase in NI remained significant after multivariate analysis β coefficient (0.08). PD patients had the greatest increase in TBF, with a significant increase in visceral fat (VFA:SFA ratio β coefficient = 0.23).
  
  
  CONCLUSIONS
  Obese patients showed preservation of TBP compared with normal- and overweight patients, suggesting that energy storage as fat mass is of value in the dialysis population.
authors: Department of Nephrology, Monash Medical Centre, Clayton, Victoria, Australia. rebecca.pellicano@med.monash.edu.au
authors: Rebecca
authors: R
authors: Pellicano
authors: Boyd J
authors: BJ
authors: Strauss
authors: Kevan R
authors: KR
authors: Polkinghorne
authors: Peter G
authors: PG
authors: Kerr
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000368:Aged; D000704:Analysis of Variance; D001823:Body Composition; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009501:Neutron Activation Analysis; D009752:Nutritional Status; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010530:Peritoneal Dialysis / Q000009:adverse effects; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006435:Renal Dialysis / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014739:Victoria