Can Bioimpedance Measurements of Lean and Fat Tissue Mass Replace Subjective Global Assessments in Peritoneal Dialysis Patients?

Paudel, Klara; Visser, Annemarie; Burke, Sinead E.; Samad, Nasreen; Fan, Stanley

doi:10.1053/j.jrn.2015.05.003

Cited by 24 publications

(31 citation statements)

References 17 publications

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“…PhA was already shown to be a good marker of nutritional status in dialysis patients, strongly associated with high MIS and consequential inferior patients' prognosis. Patients with low values of PhA were therefore recognized to need more intensive observation, diagnostic and nutritional intervention . In accordance with the former, a significant negative correlation was observed in our study between PhA and MIS.…”

Section: Discussionsupporting

confidence: 75%

“…In accordance with the former, a significant negative correlation was observed in our study between PhA and MIS. Similar results were obtained from a related study on PD patients, where time consuming diagnostic tool for malnutrition was intended to be replaced with fast and simple BIA measurements, and especially PhA .…”

Section: Discussionsupporting

confidence: 75%

“…Given that BMI is not a proper measure of body composition (and hence an elevated BMI could very well represent higher muscle mass or lean body mass), it is of interest to examine the role of measures that directly assess muscle mass and fat mass. PhA and BIA assessment with data about LTI, FTI and OH index seem to be very useful and important diagnostic tools .…”

Section: Discussionmentioning

confidence: 99%

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Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis

et al. 2016

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Malnutrition is very common and connected with high morbidity and mortality of patients on chronic hemodialysis. A cross-sectional, longitudinal study was performed in maintenance dialysis patients intending to determine association between modified Subjective Global Assessment (SGA), serum albumin and mortality. Cross-sectional study of phase angle (PhA) values and other indices of bioelectrical impedance body analysis (BIA) were correlated to biochemical data and malnutrition-inflammation score (MIS). In the group of 184 hemodialysis patients, we found 39 malnourished patients. In overall 50 months of observation, 25 out of 39 malnourished patients died. All patients with albumin values less than 30 g/L died. The group with albumin values greater than 30 g/L (N = 26) showed higher survival rate, 12 patients died in the observed period. SGA values higher than 21 and albumin values lower than 30 g/L are useful predictors of death in malnourished dialysis patients. PhA is an independent predictor of malnutrition with promising potential to replace other diagnostic tools.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis

et al. 2016

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“…For example, LTI has been demonstrated to be independently related to patients' survival, 16,17,31 and in some other study, the sensitivity of LTI was shown to be even better than Subjective Global Assessment. 32 Since 2008, the operative definition of PEW syndrome has described a much clearer picture for malnutrition in dialysis population. 33 The pivotal role of protein wasting in PEW justified the use of LTI as a surrogate of dialysis patients' nutritional status in this study.…”

Section: Discussionmentioning

confidence: 99%

A Practical Standardized Composite Nutrition Score Based on Lean Tissue Index: Application in Nutrition Screening and Prediction of Outcome in Hemodialysis Population

Chen¹,

Chen²,

Hou

et al. 2017

Journal of Renal Nutrition

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“…However, there has been little research on the appropriate use of BCM parameters for assessment of the nutritional status of HD patients. Several studies have documented that the lean tissue index (LTI) was a powerful predictor of mortality in HD patients [7][8][9]. Since the algorithms for cutoff points of LTI and fat tissue index (FTI) were derived from normal subjects and predominantly Caucasians, it remains unclear whether low LTI and/or FTI were associated with increased mortality in Asian HD patients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of body composition monitoring for assessment of nutritional status in hemodialysis patients

et al. 2019

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Background: Body composition monitoring is the only clinically available method for distinguishing among the three body components. This study aimed to determine the relationship between body composition and all-cause mortality in Chinese hemodialysis patients and examine whether the lean tissue index (LTI) derived from body composition monitoring can accurately diagnose malnourished patients. Methods: Hemodialysis patients (n ¼ 123) with nutritional and body composition assessment records in 2015 were examined. Body composition was assessed using a body composition monitor machine. Results: Fifty-seven patients (46.3%) had low LTI (LTI less than the 10th percentile of the respective normal distribution). Significant differences in the fat tissue index (FTI) were observed, with the low LTI group having a higher FTI (10.8 kg/m 2 vs. 9.0 kg/m 2 , p¼ .007). The kappa coefficient of agreement between LTI and subjective global assessment (SGA) was 0.26 for the presence of malnutrition. During the mean observation period of 26.7 months, 20 of 123 (16.3%) patients died. Low LTI remained highly predictive of survival in the Cox regression analysis (hazard ratio: 3.24, 95% confidence interval 1.06-9.91, p¼ .04). Malnourishment defined by SGA predicted survival in the Kaplan-Meier analysis (log-rank v 2 ¼4.05; p¼ .04) but not in the multivariate analysis. Conclusions: LTI is a predictor of mortality, and its predictive power was not affected when FTI, SGA, and hydration status were included in the multivariate analysis. However, SGA may not be adequate to identify patients at a risk of death among Chinese hemodialysis patients.

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Can Bioimpedance Measurements of Lean and Fat Tissue Mass Replace Subjective Global Assessments in Peritoneal Dialysis Patients?

Cited by 24 publications

References 17 publications

Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis

Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis

A Practical Standardized Composite Nutrition Score Based on Lean Tissue Index: Application in Nutrition Screening and Prediction of Outcome in Hemodialysis Population

Evaluation of body composition monitoring for assessment of nutritional status in hemodialysis patients

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