Comparison of Body Mass Index, Skinfold Thickness, and Bioelectrical Impedance Analysis With Dual‐Energy X‐Ray Absorptiometry in Hemodialysis Patients

Background Malnutrition is a consistent finding in hemodialysis (HD) patients and is associated with high mortality. The aim was to compare nutrition status indicators using dual‐energy x‐ray absorptiometry (DXA) as reference in HD patients. Methods Observational cross‐sectional study with 42 patien...

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Published in:Nutrition in clinical practice Vol. 35; no. 6; pp. 1021 - 1028
Main Authors: Abreu, Aline Miroski, Wilvert, Luana Cristina, Wazlawik, Elisabeth
Format: Journal Article
Language:English
Published: United States 01-12-2020
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Summary:Background Malnutrition is a consistent finding in hemodialysis (HD) patients and is associated with high mortality. The aim was to compare nutrition status indicators using dual‐energy x‐ray absorptiometry (DXA) as reference in HD patients. Methods Observational cross‐sectional study with 42 patients, 55.8 years (±14.6) old, 60% male, HD 2–3 times per week for ≥3 months. HD ranged from 3 months to 28 years (median, 17.3; interquartile range, 8.73–39.0). We used body mass index (BMI) and fat mass (FM) by skinfold thickness (SFT), bioelectrical impedance analysis (BIA), and DXA. Statistical analyses used Bland‐Altman plots, Lin's concordance correlation coefficient, the paired t‐test, and Pearson or Spearman correlation. P < .05 was significant. Results SFT and DXA presented the lowest prevalence of malnutrition (2.4%) and BMI the highest (28.6%). BMI, BIA FM, and SFT FM presented strong positive correlations with DXA FM (r = 0.915; r = 0.976; r = 0.910, P < .001, respectively). BIA FM and fat‐free mass (FFM) demonstrated substantial agreement with DXA values (ρ = 0.974 and 0.960, P < .001). Thus, the measurement procedures used, SFT and BIA, underestimated %FM (−4.65% and −2.13%) and overestimated FFM (3.12 kg and 1.0 kg) according to DXA. No differences were found between mean values of BIA FM and DXA (P = .178). Conclusions Compared with DXA, BIA was the most appropriate nutrition indicator for measuring body composition.
Bibliography:Financial disclosure: This work was supported by the Post Graduate Program in Nutrition of the Federal University of Santa Catarina and Social Demand Scholarship Program/ Coordination for the Improvement of Higher Education Personnel (CAPES).
Conflicts of interest: None declared.
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ISSN:0884-5336
1941-2452
DOI:10.1002/ncp.10481