Lean Body Mass Estimation by Creatinine Kinetics, Bioimpedance, and Dual Energy X-Ray Absorptiometry in Patients on Continuous Ambulatory Peritoneal Dialysis

Bhatla, B; Moore, Harold L.; Emerson, Paul F.; Keshaviah, Prakash; Prowant, Barbara; Nolph, Karl D.; Singh, Amolak

doi:10.1097/00002480-199507000-00048

Cited by 60 publications

(46 citation statements)

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“…LBM estimated from creatinine kinetics depends on the creatinine content in the diet and the metabolic degradation of creatinine. Variations observed during repeated measures of LBM estimated using creatinine kinetics is unacceptably high (45). From the available tests we recommend relying on a panel of nutritional markers rather than any one particular test.…”

Section: C-creatinine Kineticsmentioning

confidence: 99%

Nutritional Considerations in Indian Patients on PD

Nayak¹,

Nayak²,

Prabhu³

et al. 2011

Progress in Peritoneal Dialysis

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Section: C-creatinine Kineticsmentioning

confidence: 99%

Nutritional Considerations in Indian Patients on PD

Nayak¹,

Nayak²,

Prabhu³

et al. 2011

Progress in Peritoneal Dialysis

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“…Bioelectrical impedance analysis (BIA) is a portable technique of assessing body water composition that has been cross-validated in PD patients (10,11). To assess changes in body water content as a result of NPD or CAPD, we performed BIA measurements using Nutrigard-M Bioelectrical Impedance Analyzer (Data Input GmbH, Darmstadt, Germany) while the patient was supine on a bed for at least 15 min on the night of PSG study before and the morning after NPD or the night dwell of CAPD with the peritoneum emptied.…”

Section: Bioelectrical Impedance Analysismentioning

confidence: 99%

Alleviation of Sleep Apnea in Patients with Chronic Renal Failure by Nocturnal Cycler–Assisted Peritoneal Dialysis Compared with Conventional Continuous Ambulatory Peritoneal Dialysis

Tang¹,

Lam²,

Ku³

et al. 2006

Journal of the American Society of Nephrology

130

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Nocturnal hemodialysis has been shown to improve sleep apnea in patients who receive conventional hemodialysis. It was hypothesized that nocturnal peritoneal dialysis (NPD) also is effective in correcting sleep apnea in patients who receive continuous ambulatory PD (CAPD). Overnight polysomnography (PSG) was performed in 46 stable NPD and CAPD patients who were matched for demographic and clinical attributes. The prevalence of sleep apnea, defined as an apnea-hypopnea index (AHI; or frequency of apnea and hypopnea per hour of sleep) >15, was 52% for NPD patients and 91% for CAPD patients (P ‫؍‬ 0.007). The mean (؎SD) AHI in NPD and CAPD patients was 31.6 ؎ 25.6 and 50.9 ؎ 26.4 (P ‫؍‬ 0.025), respectively. For validation of the efficacy of NPD in alleviating sleep apnea, a fixed sequence intervention study was performed in which 24 incident PD patients underwent one PSG study during mandatory cycler-assisted NPD while awaiting their turn for CAPD training and a second PSG recording shortly after they were established on stable CAPD. The prevalence of sleep apnea was 4.2% during NPD and 33.3% during CAPD (P ‫؍‬ 0.016). AHI increased from 3.4 ؎ 1.34 during NPD to 14.0 ؎ 3.46 during CAPD (P < 0.001). With the use of bioelectrical impedance analysis, total body water content was significantly lower during stable NPD than CAPD (32.8 ؎ 7.37 versus 35.1 ؎ 7.35 L; P ‫؍‬ 0.004). NPD delivered greater reductions in total body water (؊2.81 ؎ 0.45 versus ؊1.34 ؎ 0.3 L; P ‫؍‬ 0.015) and hydration fraction (؊3.63 ؎ 0.64 versus ؊0.71 ؎ 0.52%; P ‫؍‬ 0.005) during sleep. Pulmonary function tests remained unchanged before and after conversion from NPD to CAPD. These findings suggest that NPD may have a therapeutic edge over CAPD in sleep apnea that is associated with renal failure as a result of better fluid clearance during sleep.

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“…The increased risk of mortality associated with protein energy wasting is often confounded by the association between increasing co-morbidity, both physical and psychological, and poor nutrition [2]. As there is currently no gold standard measurement for determining protein energy wasting, the K/DOQI guidelines recommended a combination of methods and assessments [1], including serum albumin measurement, calculation of creatinine generation rate [3], dietary diaries and interviews, subjective global assessment (SGA), anthropometric assessment [4], comparison with an estimation of ideal body weight, dual-energy X-ray absorptiometry (DEXA) scanning and bioimpedance. However, many of the simpler methods are prone to error, due to a combination of measurement and observer error or bias, or patient recall [5], and the difficulty in assessing body composition [6], as the equations used to estimate body water and fat-free mass (FFM) were typically developed from historic healthy cohorts [7,8].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Body Composition in Peritoneal Dialysis Patients Using Bioelectrical Impedance and Dual-Energy X-Ray Absorptiometry

Fürstenberg

Davenport²

2011

Am J Nephrol

128

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Introduction: Protein energy wasting is closely related to increased morbidity and mortality in peritoneal dialysis (PD) patients. Simple reliable and easily available methods of determining nutritional status and recognition of short-term changes in body composition are therefore important for clinical practice. Methods: We compared whole-body and segmental composition using multifrequency bioelectrical impedance analysis (MF-BIA) and dual-energy X-ray absorptiometry (DEXA) in 104 stable PD patients. Results: Assessment of whole-body composition showed that lean body mass (LBM) was highly correlated with good method agreement using DEXA as the reference test (r = 0.95, p < 0.0001; bias –0.88 kg, 95% CI –1.53 to 0.23 kg). Similarly, high correlation and good method agreement were found for fat mass (r = 0.93, p < 0.0001; bias 0.69 kg, 95% CI 0.03–1.36 kg). Segmental analysis of LBM revealed strong correlations between LBM for trunk, left and right arms and legs (r = 0.90, 0.84, 0.86, 0.89 and 0.90, respectively, p < 0.0001). Bone mineral content derived by MF-BIA overestimated that measured by DEXA (bias 0.740 kg, 95% CI 0.66–0.82 kg). Conclusion: MF-BIA may potentially be a useful tool for determining nutritional status in PD patients and serial estimations may help recognize short-term changes in body composition.

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Lean Body Mass Estimation by Creatinine Kinetics, Bioimpedance, and Dual Energy X-Ray Absorptiometry in Patients on Continuous Ambulatory Peritoneal Dialysis

Cited by 60 publications

References 0 publications

Nutritional Considerations in Indian Patients on PD

Nutritional Considerations in Indian Patients on PD

Alleviation of Sleep Apnea in Patients with Chronic Renal Failure by Nocturnal Cycler–Assisted Peritoneal Dialysis Compared with Conventional Continuous Ambulatory Peritoneal Dialysis

Assessment of Body Composition in Peritoneal Dialysis Patients Using Bioelectrical Impedance and Dual-Energy X-Ray Absorptiometry

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