title: Changes in body composition parameters in patients on haemodialysis and peritoneal dialysis.
abstract: BACKGROUND
  Proper hydration is one of the major aims in haemodialysis (HD) and peritoneal dialysis (PD). Bioimpedance spectroscopy appears to be a promising method for the evaluation and follow up of the hydration status in dialysis patients (P).
  
  
  OBJECTIVE
  We compared body composition between stable patients on HD and PD after six months.
  
  
  METHODS
  An observational study with 62 P on HD and 19 P on PD was performed. Clinical, biochemical and bioimpedance parameters were analysed.
  
  
  RESULTS
  In the comparative study, PD P were younger (50 ± 10 vs 57 ± 14 years, P=.031). The Charlson Comorbidity Index (4.8 ± 3 vs 7.5 ± 3, P<.001), time on dialysis (16.9 ± 18.01 vs 51.88 ± 68.79 months, P=.020) and C-Reactive Protein [3 (3-9.3) vs 5.25 (1-76.4)] were lower. Total protein levels (7.46 ± 0.44 vs 7.04 ± 0.55 g/dl, P=.005) and transferrin levels (205 ± 41 vs 185 ± 29 mg/dl, P=.024) were higher. BIS: Intracellular water (19.67 ± 3.61 vs 16.51 ± 3.36 litres, P=.010), lean tissue mass (LTM) (37.20 ± 8.65 vs 32.57 ± 8.72 kg, P=.029), total cellular mass (TCM) (20.53 ± 5.65 vs 17.56 ± 5.91 kg, P=.033), and bioelectrical impedance phase angle (Phi 50) (5.81 ± 0.86 vs 4.74 ± 0.98, P=.000) were higher than in HD P. Overhydration: 22% in HD y 10% in PD, in conditions referred to in methods. Six months later, PD P increased in weight (73.75 ± 12.27 vs 75.22 ± 11.87 kg, P=.027), total fat (FAT) (26.88 ± 10 vs 30.02 ± 10 kg, P=.011) and relative fat (Rel FAT) (35.75 ± 9.87 vs 39.34 ± 9.12, P=.010); and decreased in ICW (18.56 ± 3.45 vs 17.65 ± 3.69 l, P=.009), LTM (36.95 ± 8.88 vs 34 ± 9.70 kg, P=.008) and relative LTM (Rel LTM) (50.85 ± 12.33 vs 45.40 ± 11.95%, P=.012). In the multivariate analysis, weight variation (∆) was related to ∆ FAT (P < .001). We found a correlation between fat increase and lean tissue mass decrease. Six months later, in HD P, we observed a reduction in ECW (15.11 ± 2.45 vs 14.00 ± 2.45, P.001), without changes in other parameters.
  
  
  CONCLUSIONS
  Bioelectrical impedance analysis facilitates the assessment of changes in body composition so as to correct dry weight and to introduce changes in treatment schedule..
authors.affiliation: Servicio de Nefrología, Hospital Severo Ochoa, Leganés, Madrid. mdigioia@intramed.net.ar
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Di-Gioia
authors.forename: Paloma
authors.initials: P
authors.lastname: Gallar
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodríguez
authors.forename: Nuria
authors.initials: N
authors.lastname: Laso
authors.forename: Ramiro
authors.initials: R
authors.lastname: Callejas
authors.forename: Olimpia
authors.initials: O
authors.lastname: Ortega
authors.forename: Juan C
authors.initials: JC
authors.lastname: Herrero
authors.forename: Ana
authors.initials: A
authors.lastname: Vigil
mesh_terms: D001823:Body Composition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D013997:Time Factors