Risk identification in haemodialysis patients by appropriate body composition assessment.
BACKGROUND
Circumstances such as gender, age, diabetes mellitus (DM) and renal failure impact on the body composition of patients. However, we use nutritional parameters such as lean and fat tissue with reference values from healthy subjects to assess the nutritional status of haemodialysis (HD) patients.


OBJECTIVE
To analyse body composition by bioimpedance spectroscopy (BIS) of 6395 HD patients in order to obtain reference values of lean tissue index (LTI) and fat tissue index (FTI) from HD patients; and to confirm its validity by showing that those patients with LTI below the 10th percentile calculated for their group have greatest risk of death.


METHODS
We used the BIS to determine the LTI and FTI in our cohort of HD patients in Spain. We calculated the 10th percentile and 90th percentile of LTI and FTI in each age decile for patients grouped by gender and presence of DM. We collected clinical, laboratory and demographic parameters.


RESULTS
The LTI/FTI 10 and 90 percentile values varied by group (age, gender and presence of DM) and, after adjusting for other risk factors such as fluid overload, those patients with LTI lower than percentile 10 had a higher relative risk of death (OR 1.57) than those patients with higher values.


CONCLUSIONS
Monitoring the LTI and FTI of patients on HD using suitable reference values may help to identify risk in this patient population.
Fresenius Medical Care, Tres Cantos (Madrid), España. Electronic address: sandracastellanogasch@gmail.com.
Sandra
S
Castellano
Fresenius Medical Care, Tres Cantos (Madrid), España.
Inés
I
Palomares
Fresenius Medical Care, Bad Homburg, Alemania.
Ulrich
U
Moissl
Fresenius Medical Care, Bad Homburg, Alemania.
Paul
P
Chamney
Fresenius Medical Care, Tres Cantos (Madrid), España.
Diana
D
Carretero
Fresenius Medical Care, Tres Cantos (Madrid), España.
Antonio
A
Crespo
Fresenius Medical Care, Tres Cantos (Madrid), España.
Camilo
C
Morente
Fresenius Medical Care, Tres Cantos (Madrid), España.
Laura
L
Ribera
Fresenius Medical Care, Bad Homburg, Alemania.
Peter
P
Wabel
Fresenius Medical Care, Tres Cantos (Madrid), España.
Rosa
R
Ramos
Fresenius Medical Care, Tres Cantos (Madrid), España.
José Ignacio
JI
Merello
D000273:Adipose Tissue / Q000473:pathology; D000368:Aged; D001823:Body Composition; D003928:Diabetic Nephropathies / Q000473:pathology / Q000628:therapy; D058266:Dielectric Spectroscopy; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment
Fluid overload; Haemodialysis; Hemodiálisis; Lean tissue index; Mortalidad; Mortality; Riesgo; Risk; Sobrehidratación; Índice de tejido magro