Comparison of Body Composition Assessed by Multi-Frequency Segmental Bioelectrical Impedance Analysis and Dual Energy X-Ray Absorptiometry in Hemodialysis Patients

Abstract

Background: The assessment of body composition during the course of treatment of hemodialysis patients is crucial for optimal treatment. We intended to assess the diagnostic performance of bioelectrical impedance analysis (BIA), which could be used at the bedside in dialysis wards, and compare it with the results of dual-energy X-ray absorptiometry (DEXA). Methods: In a cross-sectional study, 43 patients with end-stage renal disease (ESRD) after hemodialysis sessions underwent direct segmental multi-frequency BIA. Volume status and body composition indices with eight electrodes connected to four limbs were measured at 1, 5, 50, 250, 500, and 1000 kHz frequencies. Then, the patients were sent to the nuclear ward for the corresponding assessments by DEXA. The results of the two methods were compared by a paired t-test and the correlations were assessed using general linear models and regression analyses. For the assessment of agreements, Bald-Altman plots were used. Results: The whole body values for bone, fat, and lean body mass were different between BIA (3.4, 22, and 44.5 kg, respectively) and DEXA (1.5, 28.5, and 40.4 kg, respectively). However, the results were strongly linearly correlated even after adjustment for age and sex (r = 0.67, P = 0.001 for bone mass; r = 0.93, P = 0.001 for fat mass; and r = 0.96, P = 0.001 for lean body mass). The same strong correlation was found for the segmental values. Conclusions: The results of BIA and DEXA are correlated strongly and are interchangeable. As the BIA is more easily available and less expensive, the routine use of BIA at hemodialysis departments is reasonable.

Alteration in body water compartments following intermittent fasting in Ramadan

“…The body composition was evaluated based on a bioelectrical impedance analysis by InBody S10 body water analyzer (InBody, Seoul, South Korea). This method was previously validated for the assessment of body composition in Iranian people ( 23 ). Generally, this device applies a small alternating current to the body via tetrapolar eight-point tactile electrodes and separately measures the impedance of the trunk, arms, and legs at six different frequencies, including 1, 5, 50, 250, 500, and 1000 kHz.…”

Association between nutritional, inflammatory and oxidative status (NIOS) and risk of adverse outcomes in patients on haemodialysis (HD): the NIOS-HD prospective cohort study protocol

“… 36 Bioelectrical impedance analysis has been found to be a reliable and valid instrument for body composition assessment in Iranian haemodialysis patients. 37 …”

“…This measurement will be performed in the morning, in a fasting state and after emptying the bladder 36. Bioelectrical impedance analysis has been found to be a reliable and valid instrument for body composition assessment in Iranian haemodialysis patients 37…”

“…36 Bioelectrical impedance analysis has been found to be a reliable and valid instrument for body composition assessment in Iranian haemodialysis patients. 37 Dietary intake A semiquantitative Food Frequency Questionnaire that contained 168 food items will be used to assess the consumption of specific foods and food groups. The reliability and validity of this questionnaire have been previously evaluated and found to be acceptable in Iranians.…”

Fundamentals, Recent Advances, and Future Challenges in Bioimpedance Devices for Healthcare Applications

“…Moreover, DEXA which possibly underestimates FFM, which agrees with the estimates made by bioimpedance [204], does not allow evaluating the distribution of TBW between ECW and ICW so as to estimate body cell mass [205] and BIA has the advantage over DEXA of avoiding radiation exposure. As the BIA method is simpler, less invasive, and less expensive, its routine clinical use is reasonable [206]. Most studies on BIA also show its usefulness in the evaluation of changes in body composition [207].…”