[Body composition assessment in patients with chronic renal failure]. / Evaluación de la composición corporal en pacientes con insuficiencia renal crónica.

INTRODUCTION: Assessment of body composition is paramount in early assessment of nutritional status impairments due to excess or deficit. There are, however, few field reliable methods for this objective for patients with chronic renal failure (CRF.). OBJECTIVE: To assess the reliability of the estimations of body composition by different methods as compared to dual energy X-ray absorptiometry (DEXA) as the gold standard method in patients with CRF and on regular chronic haemodialysis. PATIENTS AND METHODS: We assessed body composition in 30 haemodialysis patients (46.9 +/- 15.1 years (18-76); BMI 25.9 +/- 5.7 kg/m(2) (18.1-41.5)), observing agreement in the percentage of fat mass (%FM) between the sum of the 4 folds (SP; calibrator Lange) and bioimpedantiometry by using different equations (BIA; Biodynamics 450) versus DEXA (Lunar DPX-L). RESULTS: (X +/- SD) By BMI, 3 subjects had low weight (10%), 14 normal weight (46.7%), 7 overweight (23.3%), and 6 obesity (20%). The %FM with SP (30.7 +/- 7.1%) significantly differed from DEXA (27.3 +/- 10.3%; p < 0.001). With BIA there was a significant difference in %FM with the Deurenberg and Formica equations. The %FM obtained with the manufacturer's equations (Segal, Lukaski and Kyle) did not show a significant difference from DEXA. With Kyle's equation we observed a better agreement (difference with DEXA: -0.58 +/- 4.2%). CONCLUSIONS: We found a low percentage of patients with low weight as compared to previous studies. The skin folds show low reliability to estimate the fat mass. The bioimpedantiometry, using Kile's equation may be a good filed method to assess haemodialysis patients.

Evaluación de la composición corporal en pacientes con insuficiencia renal crónica / Body composition assessment in patients with chronic renal failure

Introducción: La evaluación de la composición corporal es de gran importancia en la pesquisa temprana de alteraciones en el estado nutricional por déficit o por exceso, sin embargo existen pocos métodos de campo confiables para este objetivo en pacientes con insuficiencia renal crónica (IRC). Objetivo: Evaluar la confiabilidad de estimaciones de composición corporal con distintos métodos en comparación con absorciometría de rayos X de doble energía (DEXA) como método de referencia, en pacientes portadores de IRC sometidos a hemodiálisis crónica periódica. Pacientes y métodos: Se evaluó la composición corporal en 30 pacientes en hemodiálisis (46,9 ± 15,1 años (18-76); IMC 25,9 ± 5,7 kg/m2 (18,1-41,5)), observando la concordancia en el porcentaje de masa grasa (%MG) entre sumatoria de 4 pliegues (SP; calibrador Lange®) y bioimpedanciometría usando distintas ecuaciones (BIA; Biodynamics® 450) contra DEXA (Lunar DPX-L). Resultados: (X ± DE) Según IMC, 3 individuos tenían bajo peso (10%), 14 normopeso (46,7%), 7 sobrepeso (23,3%) y 6 obesidad (20%). El %MG con SP (30,7 ± 7,1%) difirió significativamente de DEXA (27,3 ± 10,3%; p < 0,001). Para BIA hubo diferencia significativa en %MG con ecuaciones de Deurenberg y Formica. El %MG obtenido con ecuaciones del equipo, de Segal, Lukaski y Kyle, no mostró diferencia significativa con DEXA. Con Kyle se observó la mejor concordancia (diferencia con DEXA: -0,58 ± 4,2%). Conclusiones: Se encontró un bajo porcentaje de pacientes con bajo peso con respecto a estudios previos. Los pliegues cutáneos muestran una baja confiabilidad para estimar la masa grasa. La bioimpedanciometría, utilizando la ecuación de Kyle, podría ser un buen método de campo para la evaluación de pacientes en hemodiálisis (AU)

Introduction: Assessment of body composition is paramount in early assessment of nutritional status impairments due to excess or deficit. There are, however, few field reliable methods for this objective for patients with chronic renal failure (CRF.). Objective: To assess the reliability of the estimations of body composition by different methods as compared to dual energy X-ray absorptiometry (DEXA) as the gold standard method in patients with CRF and on regular chronic haemodialysis. Patients and methods: We assessed body composition in 30 haemodialysis patients (46.9 ± 15.1 years (18-76); BMI 25.9 ± 5.7 kg/m2 (18.1-41.5)), observing agreement in the percentage of fat mass (%FM) between the sum of the 4 folds (SP; calibrator Lange®) and bioimpedantiometry by using different equations (BIA; Biodynamics® 450) versus DEXA (Lunar DPX-L). Results: (X ± SD) By BMI, 3 subjects had low weight (10%), 14 normal weight (46.7%), 7 overweight (23.3%), and 6 obesity (20%). The %FM with SP (30.7 ± 7.1%) significantly differed from DEXA (27.3 ± 10.3%; p < 0.001). With BIA there was a significant difference in %FM with the Deurenberg and Formica equations. The %FM obtained with the manufacturer's equations (Segal, Lukaski and Kyle) did not show a significant difference from DEXA. With Kyle's equation we observed a better agreement (difference with DEXA: -0.58 ± 4.2%). Conclusions: We found a low percentage of patients with low weight as compared to previous studies. The skin folds show low reliability to estimate the fat mass. The bioimpedantiometry, using Kile's equation may be a good filed method to assess haemodialysis patient (AU)