Chronic kidney disease. Protein energy wasting. Nutritional assessment. Phase angle. Mid arm circumference.

Abstract

Background: Choosing the method of nutritional assessment is essential for proper follow-up of the nutritional status of patients undergoing liver transplantation. Objectives: Evaluate and compare the nutritional status of cirrhotic patients before and after liver transplantation over a year by different methods of nutritional assessment. Methods: Patients undergoing liver transplantation were assessed in five phases: pre-transplant, 1, 3, 6 and 12 months after transplantation at the hospital Santa Casa de Misericordia de Porto Alegre, RS, Brazil. The methods used for nutritional assessment were anthropometry, grip strength of the non-dominant hand (HGS) by dynamometry, thickness of the adductor pollicis muscle (APM) and phase angle (PA) by bioelectrical impedance analysis (BIA). In all evaluations, the same measurements were taken. Results: Evaluations were performed in 22 patients. Methods that showed a higher prevalence of malnourished patients before transplantation were PA by BIA (25%), arm muscle circumference (AMC) (21.9%) and arm circumference (AC) (18.8%). When comparing the nutritional status of patients during follow-up, there was a significant difference only in the evaluation methods AC, triceps skinfold thickness and PA by BIA. At the end, the methods of nutritional assessment were compared again. They showed a significant statistical difference, with HGS being the best method for detecting malnutrition. Conclusions: In conclusion, it is suggested that the method PA by BIA could be widely used with this population since the results are consistent with other findings in the literature and they are significant, reliable, and reproducible.Aydos ME, Fernandes SA, Nunes FF, Bassani L, Leonhardt LR, Harter DL, Pivato B, Miranda D, Marroni CA. One-year follow-up of the nutritional status of patients undergoing liver transplantation. Nutr Hosp 2016;33:8-13 Palabras clave: Evaluación nutricional. Cirrosis. Bioimpedancia. Trasplante hepático. ResumenIntroducción: la elección del método para la evaluación nutricional es fundamental para el correcto seguimiento del estado nutricional de los pacientes sometidos al trasplante de hígado. Objetivos: evaluar y comparar el estado nutricional de los pacientes antes y después del trasplante de hígado por el tiempo de un año para los diferentes métodos de evaluación nutricional. Métodos: se evaluaron los pacientes que se sometieron a un trasplante de hígado en diferentes momentos: pretrasplante, 1, 3, 6 y 12 meses después del procedimiento, en la Hermandad de la Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil. Los métodos utilizados fueron la antropometría, la fuerza de apretón de manos por la fuerza de agarre no dominante (FAM), el espesor del músculo aductor del pulgar y el ángulo de fase (AF) por bioimpedancia eléctrica (BIA). En todas las evaluaciones se tomaron las mismas medidas. Resultados: las evaluaciones se llevaron a cabo en 22 pacientes. Los métodos que mostraron mayor prevalencia de pacientes desnutridos antes del trasplante fueron la FA por BIA (25%),...

Bioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness

“…In 89 ICU patients, a PhA less than less than 5.5° showed an accuracy of 79% in identifying patients at high nutrition risk (NUTRIC score ≥5) [ 19 ▪ ]. In renal replacement therapy patients, a PhA cut-off of 4.6° has been shown to predict malnutrition, defined by protein--energy wasting [ 36 , 37 ]. A study comparing the accuracy of BIVA, versus the definition according to ESPEN in hospitalized patients, in predicting malnutrition, found that BIVA might be the superior method [ 38 ].…”

Phase angle as a prognostic indicator in critically ill children: A systematic review

“…The PhA has been used as an predictor of health status in different clinical situations, 6 such as undernutrition, 7,8 liver diseases, 9 chronic kidney disease, 10,11 and critical illness 12,13 …”

“…3 Because of the geometric relationship between resistance and reactance, which includes body cell mass and fluids, PhA still reflects cell function and integrity even in hyperhydration status. 2 The PhA has been used as an predictor of health status in different clinical situations, 6 such as undernutrition, 7,8 liver diseases, 9 chronic kidney disease, 10,11 and critical illness. 12,13 The PhA at 50 kHz frequency has been shown to be a predictive parameter for prognosis and mortality in critically ill adults.…”