Changes in Body Composition in the Two Years after Initiation of Haemodialysis: A Retrospective Cohort Study.
Malnutrition is common in haemodialysis (HD) and is linked to poor outcomes. This study aimed to describe changes in body composition after the initiation of HD and investigate whether any routinely collected parameters were associated with these changes. The study cohort came from the HD population of a single centre between 2009 and 2014. Body composition measurements were obtained from a database of bioimpedance results using the Body Composition Monitor (BCM), while demographics and laboratory values came from the renal unit database. Primary outcomes were changes in normohydration weight, lean tissue mass and adipose tissue mass over the two years after HD initiation. A total of 299 patients were included in the primary analyses, showing an increase in adipose tissue, loss of lean tissue and no significant change in normohydration weight. None of the routinely collected parameters were associated with the lean tissue changes. Loss of lean tissue over the first year of dialysis was associated with increased mortality. The results showing loss of lean tissue that is not limited to those traditionally assumed to be at high risk supports interventions to maintain or improve lean tissue as soon as possible after the initiation of HD. It highlights the importance of monitoring nutrition and the potential for routine use of bioimpedance.
Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK. david.keane@nhs.net.|Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK. david.keane@nhs.net.|NIHR Devices for Dignity Healthcare Technology Co-operative, Sheffield Teaching Hospitals Trust, Sheffield S102JF, UK. david.keane@nhs.net.
David
D
Keane
Department of Nutrition and Dietetics, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK. claire.gardiner2@nhs.net.
Claire
C
Gardiner
Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK. elizabeth.lindley@nhs.net.|Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK. elizabeth.lindley@nhs.net.|NIHR Devices for Dignity Healthcare Technology Co-operative, Sheffield Teaching Hospitals Trust, Sheffield S102JF, UK. elizabeth.lindley@nhs.net.
Elizabeth
E
Lindley
Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich NR4 7UY, UK. simon.lines@nnuh.nhs.uk.
Simon
S
Lines
Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK. graham.woodrow@nhs.net.
Graham
G
Woodrow
Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK. mark.wright8@nhs.net.
Mark
M
Wright
D000273:Adipose Tissue; D000368:Aged; D001823:Body Composition; D015331:Cohort Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D008875:Middle Aged; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D012044:Regression Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies
bioelectrical impedance; body composition; hemodialysis; nutrition assessment