title: Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.
abstract: OBJECTIVE
  Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment.
  
  
  METHODS
  In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients.
  
  
  RESULTS
  Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology.
  
  
  CONCLUSIONS
  Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.
authors.affiliation: Department of Internal Medicine, section of Nephrology, Holbæk Hospital, Health Sciences faculty, University of Copenhagen, Holbaek, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Koefoed
authors.affiliation: Department of Dermatology, Roskilde Hospital, Health Sciences faculty, University of Copenhagen, Roskilde, Denmark.
authors.forename: Charles Boy
authors.initials: CB
authors.lastname: Kromann
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen N, Denmark.
authors.forename: Sophie Ryberg
authors.initials: SR
authors.lastname: Juliussen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen N, Denmark.
authors.forename: Danni
authors.initials: D
authors.lastname: Hvidtfeldt
authors.affiliation: Department of Internal Medicine, section of Nephrology, Roskilde Hospital, Health Sciences faculty, University of Copenhagen, Roskilde, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Ekelund
authors.affiliation: Department of Internal Medicine, section of Nephrology, Roskilde Hospital, Health Sciences faculty, University of Copenhagen, Roskilde, Denmark.
authors.forename: Niels Erik
authors.initials: NE
authors.lastname: Frandsen
authors.affiliation: Department of Internal Medicine, section of Nephrology, Roskilde Hospital, Health Sciences faculty, University of Copenhagen, Roskilde, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Marckmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000453:epidemiology*; D006435:Renal Dialysis; D055105:Waist Circumference / Q000502:physiology; D055815:Young Adult