title: The association between bioimpedance analysis and quality of life in pre-dialysis stage 5 chronic kidney disease, hemodialysis and peritoneal dialysis patients.
abstract: BACKGROUND
  Protein-energy wasting is a significant problem in End stage renal disease (ESRD) patients. Furthermore, it compromises the patient's Quality of life (QOL). Multifrequency Bioimpedance Spectroscopy (BIS) is a validated method to assess body composition in dialysis patients. There has been no data on the relationship between body composition and QOL in ESRD patients who were treated with different modalities.
  
  
  OBJECTIVE
  To explore the association between body composition as assessed by BIS and QOL in ESRD patients who received different treatment modalities.
  
  
  METHODS
  The present study is a cross sectional, descriptive analytic study of the association between QOL and BIS in ESRD patients in Burapha University, Chonburi, Thailand. QOL was assessed by WHOQOL-BREF questionnaire, body composition was measured by BIS technique. The difference between groups was tested by one-way ANOVA test, relationship between groups was tested with Pearson correlation test.
  
  
  RESULTS
  Eighteen predialysis-CKD5, 26 peritoneal dialysis (PD), and 34 hemodialysis (HD) patients were included in the present study. All PD patients had weekly Kt/V > or = 1.7 per week and all HD patients had weekly Kt/V > or = 3.6 per week. There were no statistically difference in baseline characteristics including Charlson comorbidity index, dietary intake, BMI, and blood pressure between groups. Mean QOL scores in each group were in the middle range and not significantly difference. PD patients had more over hydration when compare to HD patients (16.18 +/- 11.24 vs. 2.36 +/- 11.07 %OH/ECW p < 0.0001). There were inversed correlation between overhydration and physical health in HD patients (r = -0.372, p = 0.033) but not in PD and CKD5 patients. CKD5 patients had more lean tissue index (LTI) than PD and HD patients (LTI = 14.34 +/- 3.13, 12.26 +/- 3.65, 11.48 +/- 3.48 kg/m2 respectively, p = 0.023). There were correlation between LTI and overall QOL in CKD5 (r = 0.690, p = 0.002) and PD patients (r = 0.498, p = 0.010). In HD patients, LTI was associated with better physical health (r = 0.464, p = 0.007).
  
  
  CONCLUSIONS
  QOL in predialysis-CKD5, PD and HD patients were not statistically different. HD patients had better volume control than PD patients. Higher LTI were associated with better QOL in ESRD patients.
authors.forename: Somchai
authors.initials: S
authors.lastname: Yongsiri
authors.forename: Jiranuch
authors.initials: J
authors.lastname: Thammakumpee
authors.forename: Suriya
authors.initials: S
authors.lastname: Prongnamchai
authors.forename: Pakaphan
authors.initials: P
authors.lastname: Dinchuthai
authors.forename: Rachaneeporn
authors.initials: R
authors.lastname: Chueansuwan
authors.forename: Siriporn
authors.initials: S
authors.lastname: Tangjaturonrasme
authors.forename: Pechngam
authors.initials: P
authors.lastname: Chaivanit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D003430:Cross-Sectional Studies; D058266:Dielectric Spectroscopy; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010530:Peritoneal Dialysis; D011502:Protein-Energy Malnutrition / Q000209:etiology; D011788:Quality of Life; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy