Relationship between Lean Body Mass(LBM) by Bioelectrical Impedance Analysis(BIA) and Nutritional Parameters in Hemodialysis Patients

Hong, Seong Bin; Kim, Moon Jae; Lee, Seung Woo; Song, Joon Ho

Abstract

The incidence of protein and energy malnutrition is about 20-40% in patients on maintenance dialysis and it is an important determinant of morbidity and mortality in end-stage renal disease. The traditional methods of nutritional assessment such as body measurement and dietary assessment are relatively ineffective because of operator dependency. Biochemical data, also, have the difficulty in early detection of malnutrition. Therefore more precise and simple method such as bioelectrical impedance analysis(BIA) was needed. We perfomed a study of 25 maintenance hemodialysis patients who were clinically stable and had been on dialysis over 3 months to identify the relationship between lean body mass(LBM) by BIA and other nutritional indicators. Mean age was 43+/-12 years, sex ratio, M:F=1:1.3, and mean dialysis duration, 56+/-38.9 month. Three patients were diabetes mellitus(12%), Delivered Kt/ Vurea, serum albumin, and %LBM were 1.5+/-0.2/ session, 4.1+/-0.4g/dl and 76.5 +/-10.5%, respectively. Patients were divided into 2 groups; group I whose %LBM was less than 75%, and group II whose %LBM was more than 75%. Patients were significantly older in group I, but sex ratio, percentage of diabetes mellitus, dialysis duration were not significantly different between two groups. Serum cholesterol(175.3+/-35.2 vs. 142.5+/-24.7mg/dL) was significantly higher and serum creatinine(12.4+/-2.7 vs. 16.2+/-4.3mg/dL) was significantly lower in group I. Serum albumin and insulin-like growth factor-I (IGF-I) were similar between two groups. On data measured by BIA, LBM(67.9+/-6.1 vs. 84.4+/-1.9%), height2/resistance(39.4+/-4.3 vs. 52.7+/-8.5) were significantly lower in group I. %Body fat was significantly higher in group I(31.3+/-4.6 vs. 15.7+/-6.7%). Dietary protein intake(30+/-13.5 vs. 41.7+/-14.6g/day) and total calorie intake(1239.9+/-272.3 vs. 1329.4+/-375.0 Cal/day) were higher in group II. %LBM correlates positively with serum creatinine (r=0.41, p<0.05) and dietary protein intake(r=0.51, p<0.05), but negatively with age(r=-0.59, p<0.05) and cholesterol(r=-0.52, p<0.05). In conclusion, %LBM by BIA in maintenance hemodialysis patients appears to be well correlated with traditional nutritional study.