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Body composition, energy expenditure and physical activity

Clinical value of body composition monitor to evaluate lean and fat tissue mass in peritoneal dialysis

European Journal of Clinical Nutrition volume 73, pages 1520–1528 (2019)Cite this article

Subjects

Abstract

Background/Objectives

Bioimpedance analysis is often routinely performed in any dialysis unit to guide fluid management but can provide a reproduceable assessment of fat and muscle mass. We wished to determine the clinical significance of low muscle or high fat mass and the determinants that influence their change.

Subjects/Methods

We performed retrospective analysis of 824 patients on peritoneal dialysis who underwent routine repeated bioimpedance analysis measurements using the body composition monitor (BCM).

Results

Lean tissue index (LTI) was an independent predictor of mortality when sex, age, PD vintage and diabetes status were included in the models (HR 0.93; 95% CI 0.86–1.00, p < 0.05) and when baseline serum albumin was included in a separate model (HR 0.86; 95% CI: 0.79–0.93, p < 0.001). High fat tissue index (FTI) was an independent predictor of mortality when demographic factors were included (HR 0.87; 95% CI: 0.78–0.97, p < 0.02), but not with the addition biochemical parameters. Changes in body composition of 206 patients over a 2-year follow-up period could not be predicted by baseline demographics, functional or biochemical assessments. However, there was a strong inverse relationship between changes in LTI and FTI. There were no associations between changes in body composition with prescribed dialysate glucose.

Conclusions

We showed body composition changes are common and complex. LTI was an independent predictor of survival. Changes in LTI and FTI could not be predicted by baseline parameters. BCM may be a sensitive and accurate tool to monitor changes in body composition during dialysis treatment.

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Acknowledgements

This study was funded through local departmental funds.

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Authors and Affiliations

  1. Departments of Renal Medicine and Transplantation, Barts Health NHS Trust, London, E1 1BB, UK

    Rajeevalochana Parthasarathy, Elizabeth Oei & Stanley L. Fan

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  1. Rajeevalochana Parthasarathy
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  2. Elizabeth Oei
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  3. Stanley L. Fan
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Correspondence to Stanley L. Fan.

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Prior to 2014, SLF received lecture fees from Fresenius Medical Care.

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Parthasarathy, R., Oei, E. & Fan, S.L. Clinical value of body composition monitor to evaluate lean and fat tissue mass in peritoneal dialysis. Eur J Clin Nutr 73, 1520–1528 (2019). https://doi.org/10.1038/s41430-019-0391-3

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