Comparison of Different Measurements of Lean Body Mass in Continuous Ambulatory Peritoneal Dialysis Patients / 대한신장학회잡지

ABSTRACT

Malnutrition is common in continuous ambulatory peritoneal dialysis(CAPD) patients. Previous studies showed that 18-56% of CAPD patients were suffering from varying degrees of malnutrition. Malnutrition reflects inadequate dialysis or improper dietary intake, leading to a reduction in lean body mass(LBM). Monitoring of LBM, therefore is important for long-term nutritional assessment of CAPD patients. At present, dual energy X-ray absorptiometry(DEXA) is known to accurately predict body compositions in normal and dialysis patients. To determine the most convenient and cost effective tool for LBM measurement, the present cross- sectional study was carried out assessing LBM by DEXA as well as by four other techniques anthropometry, bioelectrical impedance analysis, infrared interactance and creatinine kinetics. 1) Subjects were 15 men and women each, all clinically stable with a mean CAPD duration of 35.5 months. The mean concentration of serum albumin was 3.9+/-0.5g/dl, normalized protein catabolic rate (NPCR) 0.98+/-0.16g/kg/day, KT/Vurea 2.08+/-0.34 and standardized creatinine clearance(SCCr) 65.8+/-22.1 l/week/1.73m2. 2) Significant correlations between LBM measured by DEXA and LBM measured by other methods were found(r >0.833, p<0.05). Compared with DEXA, the best result was found with anthropometry as it had the highest r value in both measurements of LBM and %LBM(r values are 0.899 and 0.908, respectively). 3) The mean prediction error and root mean squared prediction error was lowest between LBM by anthropometry and that by DEXA. 4) LBM showed no correlation with serum albumin, NPCR, KT/Vurea, and SCCr. In conclusion, anthropometry accurately predicts LBM and may be a suitable alternative tool compared to DEXA in stable CAPD patients.