Changes in body composition in relation to estimated glomerular filtration rate and physical activity in predialysis chronic kidney disease

Abstract

Background: Early body composition changes, associated with physical inactivity and disease advancement are devastating for patient-related outcomes in predialysis chronic kidney disease (CKD), thus warranting a detailed analysis of body composition beyond conventional measures. Methods: The study included 40 subjects diagnosed with CKD; recruited between January to May 2021. Body composition was measured using the multifrequency analyzer, InBody 770. International Physical Activity Questionnaire-Short Form was used to assess physical activity. Suitable statistical analyses were performed using SPSS 21.0. Results: The mean age of the subjects was 58.68 ± 12.24 years. Sarcopenic obesity was prevalent in 62.5% of the subjects. Body mass index under identified obesity by 15% compared to percent body fat, especially in subjects with low muscle mass. The decline in a unit of estimated glomerular filtration rate (eGFR) significantly correlated with a decrease in weight (p = 0.02), body fat mass (p = 0.05), visceral fat area (p = 0.05), and phase angle (p = 0.01) with marginal changes in waist-hip ratio and extracellular water/total body water. The effect of physical activity on skeletal muscle mass was homogeneous between low and moderate levels, but significantly different from high activity level. Conclusion: Changes in fat and fluid compartment were associated with eGFR decline, whereas higher physical activity positively affected body composition.

Application of Bioelectrical Impedance Analysis in Nutritional Management of Patients with Chronic Kidney Disease

“…Sarcopenic obesity was prevalent in 62.5% of the pre-dialysis CKD patients. In subjects with low muscle mass, a decrease in eGFR is significantly associated with a decrease in body weight, body fat mass and visceral fat area [ 38 ]. In one study, skeletal muscle mass index (SMI) measured by BIA was used to determine sarcopenia compared with anthropometric measurements or subjective global assessment (SGA), and only sarcopenia diagnosed by SMI remained as a predictor of mortality after multivariate adjustment [ 39 ].…”

“…The phase angle (PhA) of patients with advanced pre-dialysis CKD is lower than that of healthy people [ 41 ]. A decrease in phase angle was significantly associated with a decrease in estimated glomerular filtration rate (eGFR) [ 38 ]. The PhA in the diabetic chronic kidney disease stage 5 (DMCKD5) group was significantly lower than that in non-diabetic CKD stage 5 (nDMCKD5) group.…”

Application of bioelectrical impedance analysis in nutritional management of patients with chronic kidney disease

“…The phase angle (PhA) of patients with advanced pre-dialysis CKD is lower than that of healthy people [41]. A decrease in phase angle was significantly associated with a decrease in estimated glomerular filtration rate (eGFR) [38]. The PhA in diabetic chronic kidney disease stage 5 (DMCKD5) group was significantly lower than that in non-diabetic CKD stage 5 (nDMCKD5) group.…”

“…Sarcopenic obesity was prevalent in 62.5% of the pre-dialysis CKD patients. In subjects with low muscle mass, a decrease in eGFR is significantly associated with a decrease in body weight, body fat mass, and visceral fat area [38]. In one study, skeletal muscle mass index (SMI) measured by BIA was used to determine sarcopenia compared with anthropometric measurements or subjective global assessment (SGA).…”