Segment-specific resistivity improves body fluid volume estimates from bioimpedance spectroscopy in hemodialysis patients

Zhu, Fansan; Kuhlmann, Martin K.; Kaysen, George A.; Sarkar, Sourav; Kaitwatcharachai, Charoen; Khilnani, R; Stevens, Louis-Mathieu; Leonard, Edward F.; Wang, J.; Heymsfield, S. B.; Levin, Nathan W.

doi:10.1152/japplphysiol.00669.2005

Cited by 78 publications

(93 citation statements)

References 32 publications

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“…9,10 Concomitantly, in hemodialysis patients, the body shape-derived Kb factor used to adjust impedance measurements for specific segmental resistivity as part of the bioimpedance spectroskopy technique improved estimation of body fluid volume. 11 Segmental BIA has been developed to overcome inconsistencies between R and mass of the trunk, yet this technique requires further evaluation. 2 Although the body composition data presented in the results section of our study were derived from tetrapolar impedance measurements between the hand and foot of the dominant body side, we had applied a tetrapolar system that also measures segmental impedance by placing two electrodes each on both hands and feet.…”

Section: Discussionmentioning

confidence: 99%

Comparing single-frequency bioelectrical impedance analysis against deuterium dilution to assess total body water

et al. 2012

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BACKGROUND/OBJECTIVES:In this study, we aimed to validate the accuracy of single-frequency bioelectrical impedance analysis (SF-BIA) at 50 kHz to assess total body water (TBW) against the reference technique deuterium dilution (D 2 O) and to explore if the simple clinical parameters extracellular fluid (ECF) composition and body shape explain individual differences between D 2 O and SF-BIA (Diff BIA À D2O ). SUBJECTS/METHODS:We assessed TBW with D 2 O and SF-BIA in 26 women and 26 men without known disease or anomalous body shapes. In addition, we measured body shape with anthropometry and ECF composition (osmolality, albumin, glucose, urea, creatinine, sodium and potassium). RESULTS: On group average, SF-BIA to predict TBW agreed well with D 2 O (SF-BIA, 39.8 ± 10.1 l; D 2 O, 40.4 ± 10.2 l; and Diff BIA À D2O À 0.7 l). In four individuals ('outliers'; 15% of the study population), Diff BIA À D2O was high ( À 6.8 to þ 3.8 l). Diff BIA À D2O was associated with individual variations in body shape rather than ECF composition. Using gender-specific analysis, we found that individual variability of waist circumference in men and arm length in women significantly contributed to Diff BIA À D2O . When removing the four 'outliers', these associations were lost. CONCLUSIONS: In the majority of our sample, BIA agreed well with D 2 O. Adjusting for individual variability in body shape by anthropometrical assessment could possibly improve the accuracy of SF-BIA for individuals who deviate from mean values with respect to body shape. However, further studies with higher subject numbers are needed to confirm our findings.

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Section: Discussionmentioning

confidence: 99%

Comparing single-frequency bioelectrical impedance analysis against deuterium dilution to assess total body water

et al. 2012

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“…Bioelectrical impedance analysis (BIA) is inexpensive, easy to use, portable, and requires no radiation exposure [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Thus, BIA may be useful as a portable alternative to DXA [25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Developing and Validating an Age-Independent Equation of Multi-Frequency Bioelectrical Impedance Analysis for Estimation of Appendicular Skeletal Muscle Mass and Establishing Sarcopenia Cutoff

Yamada¹,

Nishizawa²,

Uchiyama³

et al. 2017

Preprint

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Background: Appendicular skeletal muscle (or lean) mass (ALM) estimated by dualenergy X-ray absorptiometry (DXA) is considered to be a preferred method for sarcopenia studies. However, DXA is expensive, has limited portability, and requires radiation exposure. Bioelectrical impedance analysis (BIA) is inexpensive, easy to use, and portable; thus BIA might be useful in sarcopenia investigations. However, a large variety of models have been commercially supplied by different companies, and for most consumer products, the equations estimating ALM are not disclosed. It is therefore difficult to use these equations for research purposes. In particular, the BIA equation is often age-dependent, which leads to fundamental difficulty in examining age-related ALM loss. The aims of the current study were: 1) to develop and validate an equation to estimate ALM using multi-frequency BIA (MF-BIA) using theoretical models, and 2) to establish sarcopenia cutoff values using the equation for the Japanese population. The mean values minus 2 standard deviations of the skeletal muscle mass index (ALM/Ht 2 ) in these participants were 6.8 and 5.7 kg/m 2 in men and women, respectively. Conclusion: the current study established and validated a theoretical and age-independent equation using MF-BIA to estimate ALM and provided reasonable sarcopenia cutoff values.

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“…Recently, Zhu F et al has significant break through with innovative advance using segment-specific resistivity to derive accurate water distribution information [32,33]. At the same time, phase angle of various body compartment was explored by Nescolarde L [34].…”

Section: Discussionmentioning

confidence: 99%

Ratio of Capacitance/BMI Reflects Deficit in Nutritional Concentration While CH2 Reflects Total Nutritional Deficit in CAPD Patients and General Population

Koh¹,

Wong²

2013

OJNeph

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Traditionally phase angle was the best predictor in BIA for nutrition and survival in dialysis population. We recently showed that normalized bioimpedance indices are a better risk discriminator for dialysis patients and the general population. We hereby aimed to explore discriminating factors behind them. Methods: We assessed the body capacitive index (BCI = Capacitance × Height ) which represents total body capacitive volume in physics. We initially performed BIA for 206 female, 116 male healthy volunteers, followed by, prospective study for 128 CAPD patients (47 diabetes mellitus (DM), 81 non-DM; 59 male, 69 female) for >2 years. Results: Moderately good negative correlation of albumin and BCI (r = −0.533, p < 0.001) with linear regression (BCI = 8.780 − 0.184 × [albumin], R 2 = 0.339, p < 0.001) was shown in CAPD patients. BCI and CH 2 were much higher in CAPD patients in comparison to healthy volunteers (3.4 ± 0.1 vs 2.0 ± 0.0 nFm 2 /kg, p < 0.001 and 203 ± 8 vs 125 ± 1 nFm 2 , p < 0.001, respectively). In age and gender adjusted logistic regression model of 128 CAPD patients versus 322 healthy volunteers, the best risk discriminator was BCI (X 2 = 165.6), followed by CH 2 (X 2 = 140), phase angle (X 2 = 59.3) and BRI (X 2 = 52.2). Thirty five (27.3%) patients died during the study period (Fatal cause: infection (54%), cardiovascular (26%)). In Cox regression, CH 2 ( 2 4 X = 32.4) was the best predictor for all-cause mortality, followed by BCI ( 2 4 X = 27.7) and phase angle ( 2 4 X = 19.3). Conclusion: The phase angle was a compound parameter of the body capacity index (BCI) and body resistive index (BRI). BCI has a moderately good negative correlation with albumin and this supports its role in reflecting the severity of malnutrition in CAPD patients. CH 2 represents total nutrition deficit and thus the major risk indicator for the survival of CAPD patients.

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Segment-specific resistivity improves body fluid volume estimates from bioimpedance spectroscopy in hemodialysis patients

Abstract: . Segment-specific resistivity improves body fluid volume estimates from bioimpedance spectroscopy in hemodialysis patients.

Cited by 78 publications

References 32 publications

Comparing single-frequency bioelectrical impedance analysis against deuterium dilution to assess total body water

Comparing single-frequency bioelectrical impedance analysis against deuterium dilution to assess total body water

Developing and Validating an Age-Independent Equation of Multi-Frequency Bioelectrical Impedance Analysis for Estimation of Appendicular Skeletal Muscle Mass and Establishing Sarcopenia Cutoff

Ratio of Capacitance/BMI Reflects Deficit in Nutritional Concentration While CH2 Reflects Total Nutritional Deficit in CAPD Patients and General Population

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