Identificar situaciones de riesgo para los pacientes en hemodiálisis mediante la adecuada valoración de su composición corporal

Castellano, Sandra; Palomares, Inés; Moissl, Ulrich; Chamney, Paul; Carretero, Diana; Crespo, Antonio Sampietro; Morente, Camilo; Ribera, Laura Badenes; Wabel, Peter; Ramos, Rosa; Merello, José Ignacio

doi:10.1016/j.nefro.2016.01.007

Cited by 18 publications

(10 citation statements)

References 31 publications

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“…Impaired QoL in these patients has a multifactorial origin, the baseline renal disease, the renal replacement therapy itself, the increased number of comorbidities, the systemic chronic inflammation and fluid overload status and the PEW syndrome being all accountable for a significantly decreased level of social, familial and professional interaction for ESRD patients receiving HD treatment [9,10,12,17]. In the last years, nutritional parameters evaluated through bioimpedance spectroscopy analysis, have gained a well-deserved place among the principal, fastest, easiest and reproducible techniques of accurate nutrition assessment [14,[18][19][20][21][22][23][24][25][26]. Low muscle mass, expressed either as LTM (kg) or LTI (kg/m 2 ), a BIS-derived parameter, was found to be associated with higher mortality in HD patients [12,13,17].…”

Section: Resultsmentioning

confidence: 99%

“…For normal range intervals, previous age, gender and height values, from references population, both general population and HD patients, were established, with values defined for LTI and FTI as low if LTI, or FTI is ≤ 10th percentile of a reference population), high if LTI or FTI is ³ ≥ 90th percentile and normal if LTI or FTI is between the 10th and the 90th percentile of the reference population [14]. Also, the references ranges for OH were established between -1.1 l and 1.1 l, values under this interval defining underhydration and overhydration, respectively.…”

Section: Assessment Of Body Composition Via Bis Measurementsmentioning

confidence: 99%

“…There are several reports that associate a low body mass index (BMI), a low lean tissue index (LTI), overhydration expressed as measured overhydration (OH), or as relative overhydration (Rel. OH) as independent predictors for mortality in HD patients [9,[12][13][14][15].…”

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confidence: 99%

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Biochemical and Bioimpedance Correlation with Quality of Life and Illness Perception in Hemodialysis Patients

Donciu¹,

Florea²,

Mititiuc³

et al. 2019

Rev. Chim.

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In hemodialysis patients malnutrition-inflammation syndrome, evaluated by biochemical laboratory analysis and through bioimpedance spectroscopy, was associated to impaired quality of life and with an increased risk of mortality. The present study goal was to investigate, in a cross-sectional analysis, performed in 122 hemodialysis patients, the association between biochemical parameters and bioimpedance-derived measurements the association of undernutrition with quality of life and illness perception. The results showed that our cohort perceived an impaired quality of life and illness perception and that these psychometric evaluation was associated with malnutrition markers.

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Section: Resultsmentioning

confidence: 99%

Section: Assessment Of Body Composition Via Bis Measurementsmentioning

confidence: 99%

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Biochemical and Bioimpedance Correlation with Quality of Life and Illness Perception in Hemodialysis Patients

Donciu¹,

Florea²,

Mititiuc³

et al. 2019

Rev. Chim.

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“…The lean tissue is composed of muscles, organs, blood and bones and can estimate the muscle mass of the whole body to reflect the storage of proteins. Hemodialysis patients presented with a decrease in LTI 30 , which was associated with adverse prognosis 11,[18][19][20][21][22][23] . Our results proved that the LTM and BCM standardized by height square (LTI and BCMI) were more associated with mortality compared with those standardized by weight (LTM/weight and BCM/weight), which may be influenced by the hydration status that was very common in hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Comparative Performance of Body Composition Parameters in Prediction of Death in Hospitalized Patients on Maintenance Hemodialysis: A Cohort Study

Yan

Zhang

et al. 2020

Sci Rep

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We compared the prognostic value of nutritional or volumetric parameters measured by body composition in hospitalized patients on maintenance hemodialysis. We conducted a cohort study to assess the association of different parameters of body composition with all-cause mortality in inpatients admitted to our nephrology department from January 2014 to December 2016. Of the 704 study patients, 160 (22.7%) died during a median follow-up of 33 months. In multivariate adjusted Cox models, higher ratio of extracellular water to body cell mass (ECW/BCM) (adjusted HR per 1-SD, 1.49; 95% CI, 1.19 to 1.85), lower lean tissue index (LTI) (adjusted HR per 1-SD, 0.70; 95% CI, 0.57 to 0.86) and lower body cell mass index (BCMI) (adjusted HR per 1-SD, 0.70; 95% CI, 0.58 to 0.85) were associated with a significantly greater risk of death. When these parameters were added to the fully adjusted model, BCMI performed best in improving the predictability for all-cause mortality (integrated discrimination improvement = 0.02, P = 0.04; net reclassification index = 0.11, P = 0.04). Among body composition indexes, ECW/BCM was the most relevant fluid volume indices to mortality and BCMI and LTI were the most relevant nutritional status indices to mortality in maintenance hemodialysis patients. End-stage renal disease (ESRD) has become one of the major health problems in the world. In 2010, it was estimated that 284 individuals per million population were undergoing maintenance dialysis throughout the world 1 , and the number of dialysis patients is growing at an alarming rate 2-5. Dialysis is the major treatment for ESRD and brings a heavy economic burden to all countries 6. Despite this, dialysis patients still have poor prognosis 5,7. The main risk factors for the mortality includes vascular access, cardiovascular complications, cerebrovascular complications, infection, anemia, mineral metabolic disorders, renal osteopathy, fluid overload (FO) and malnutrition 7,8. Bioelectrical impedance analysis-based body composition analysis is widely used and accepted as an ideal tool for assessing fluid volume and nutritional status in maintenance dialysis patients 9. It is easy-to-use, safe, noninvasive, repeatable and comprehensive. It has both anthropometric parameters in assessing fluid volume [such as overhydration (OH) 10 , OH/extracellular water (OH/ECW) 8,11-14 , the ratio of extracellular water to intracellular water (ECW/ICW) 15 , the ratio of extracellular water/body cell mass (ECW/BCM) 16,17 ] and nutrition status [such as lean tissue index (LTI) 11,18-23 , fat tissue index (FTI) 11,18 , body cell mass index (BCMI) 24,25 , BCM/weight 26 ]. However, it is still unclear which nutritional or volumetric parameters of body composition, measured by bioelectrical impedance, have the greatest prognostic value in maintenance hemodialysis patients. We designed this cohort study to assess and compare the association of different parameters in body composition with all-cause medium-term mortality in hemodialysis patients.

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“…9,10 Además, el acondicionamiento muscular deficiente ha sido reconocido como marcador de perfil metabólico anormal 11 y se ha encontrado asociado con mortalidad. [12][13][14] El IMC es ampliamente utilizado en estudios epidemiológicos para analizar la masa corporal en relación con la talla. [15][16][17] Aunque el método identifica a sujetos con peso bajo, peso normal, sobrepeso y obesidad, no permite diferenciar la masa grasa (MG) y la masa libre de grasa (MLG).…”

Section: Introductionunclassified

Determinación del estado nutricional mediante el ángulo de fase en pacientes en hemodiálisis

Topete-Reyes

López-Lozano

López-Báez

et al. 2019

GMM

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La bioimpedancia eléctrica multifrecuencia (BIE) evalúa con precisión la composición corporal. Objetivo: Investigar el estado nutricional y su relación con el índice de masa corporal (IMC) o el ángulo fase obtenido por BIE en pacientes con enfermedad renal terminal (ERT) en hemodiálisis. Método: En 99 pacientes en hemodiálisis (43.6 ± 17.2 años, 58.8 % varones) se evaluó IMC, BIE y puntuación de desnutrición (DMS, Dialysis Malnutrition Score). La independencia de las asociaciones del IMC y el ángulo fase con el DMS se determinó con regresión lineal múltiple. Resultados: El riesgo de desnutrición (DMS > 13) se incrementó gradualmente entre los sujetos con IMC y ángulo fase normales (44.4 %), IMC bajo (45.8 %), ángulo fase bajo (64.0 %) y en aquellos con ambos parámetros anormales (68.0 %). El ángulo fase fue la única variable asociada independientemente con el estado nutricional de los pacientes (coeficiente beta estandarizado −0.372, p < 0.001), lo que explicó 13.8 % de la variación en el DMS. Conclusiones: El ángulo fase se asocia inversa e independientemente con el riesgo de desnutrición en pacientes con ERT, lo que sugiere que la composición corporal evaluada por BIE pudiera ser mejor que el IMC en la valoración clínica de pacientes con esta enfermedad.

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Identificar situaciones de riesgo para los pacientes en hemodiálisis mediante la adecuada valoración de su composición corporal

Abstract: Monitoring the LTI and FTI of patients on HD using suitable reference values may help to identify risk in this patient population.

Cited by 18 publications

References 31 publications

Biochemical and Bioimpedance Correlation with Quality of Life and Illness Perception in Hemodialysis Patients

Biochemical and Bioimpedance Correlation with Quality of Life and Illness Perception in Hemodialysis Patients

Comparative Performance of Body Composition Parameters in Prediction of Death in Hospitalized Patients on Maintenance Hemodialysis: A Cohort Study

Determinación del estado nutricional mediante el ángulo de fase en pacientes en hemodiálisis

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