Abstract
Background/Objectives:
Multi-frequency bioelectrical impedance analysis (MFBIA) is becoming more widely used to assess hydration status and body composition in haemodialysis patients. Most centres only measure MFBIA pre dialysis when patients are overhydrated. We wished to determine whether body composition assessments change post dialysis following fluid removal.
Subjects/Methods:
Lean body and fat mass were measured by MFBIA pre and post haemodialysis in 676 stable outpatients.
Results:
Weight fell post dialysis from 72.9±17.8 to 70.9±19.9 kg, P<0.001, soft lean mass from 48.2±12.1 to 45.4±11.0 kg and fat-free mass from 51.8±19.2 to 48.1±11.8 kg, P<0.001, whereas percentage body fat (PBF) increased from 28.8±11.9 to 30.8±12.1% post dialysis, P<0.001, with a mean increase post dialysis of 2.0% (95% confidence limits 1.55 to 2.45). There were correlations between the fall in total body water and extracellular water and skeletal muscle mass (r=0.826, P<0.001 and r=0.711, P<0.001, respectively), and negative correlation between the fall in total body water and ICW and the increase in PBF (r=−0.72, P<0.001, and −0.72, P<0.001, respectively). The relative changes were greater for the arms compared with the legs.
Conclusions:
Although more convenient for both patients and staff to undertake bioimpedance measurements pre dialysis, overhydration over estimates muscle mass and under estimates fat. For more reliable and reproducible assessments of nutritional status, we suggest that bioimpedance measurements of body composition should be made when patients are closer to their target weight than when overhydrated.
Similar content being viewed by others
References
Davies SJ, Davenport A . The role of bioimpedance and biomarkers in helping to aid clinical decision-making of volume assessments in dialysis patients. Kidney Int 2014; 86: 489–496.
Chamney PW, Krämer M, Rode C, Kleinekofort W, Wizemann V . A new technique for establishing dry weight in haemodialysis patients via whole body bioimpedance. Kidney Int 2002; 61: 2250–2258.
Kumar S, Khosravi M, Massart A, Potluri M, Davenport A . The effects of racial differences on body composition and total body water measured by multifrequency bioelectrical impedance analysis influence delivered Kt/V dialysis dosing. Nephron Clin Pract 2013; 124: 60–66.
Davenport A, Hussain Sayed R, Fan S . The effect of racial origin on total body water volume in peritoneal dialysis patients. Clin J Am Soc Nephrol 2011; 6: 2492–2498.
Raimann JG, Zhu F, Wang J, Thijssen S, Kuhlmann MK, Kotanko P et al. Comparison of fluid volume estimates in chronic haemodialysis patients by bioimpedance, direct isotopic, and dilution methods. Kidney Int 2014; 85: 898–908.
Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gómez JM et alComposition of the ESPEN Working Group. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr 2004; 23: 1430–1453.
Fürstenberg A, Davenport A . Assessment of body composition in peritoneal dialysis patients using bioelectrical impedance and dual-energy x-ray absorptiometry. Am J Nephrol 2011; 33: 150–156.
Davenport A . Does peritoneal dialysate affect body composition assessments using multi-frequency bioimpedance in peritoneal dialysis patients? Eur J Clin Nutr 2013; 67: 223–225.
Davenport A, Argawal B, Wright G, Mantzoukis K, Dimitrova R, Davar J et al. Can non-invasive measurements aid clinical assessment of volume in patients with cirrhosis? World J Hepatol 2013; 5: 433–438.
Booth J, Pinney J, Davenport A . Do changes in relative blood volume monitoring correlate to haemodialysis-associated hypotension? Nephron Clin Pract 2011; 117: c179–c183.
Davenport A, Willicombe M . Comparison of fluid status in patients treated by different modalities of peritoneal dialysis using multi-frequency bioimpedance. Int J Artif Organs 2009; 32: 779–786.
Vernon K, Peasegood J, Riddell A, Davenport A . Dialyzers designed to increase internal filtration do not result in significantly increased platelet activation and thrombin generation. Nephron Clin Pract 2011; 117: c403–c408.
Davenport A . Low-molecular-weight heparin as an alternative anticoagulant to unfractionated heparin for routine outpatient haemodialysis treatments. Nephrology 2009; 14: 455–461.
Davenport A . Interdialytic weight gain in diabetic haemodialysis patients and diabetic control as assessed by glycated haemoglobin. Nephron Clin Pract 2009; 113: c33–c37.
Sandhu E, Crawford C, Davenport A . Weight gains and increased blood pressure in outpatient haemodialysis patients due to change in acid dialysate concentrate supplier. Int J Artif Organs 2012; 35: 642–647.
Fürstenberg A, Davenport A . Comparison of multifrequency bioelectrical impedance analysis and dual-energy X-ray absorptiometry assessments in outpatient haemodialysis patients. Am J Kidney Dis 2011; 57: 123–129.
Molfino A, Don BR, Kaysen GA . Comparison of bioimpedance and dual-energy x-ray absorptiometry for measurement of fat mass in haemodialysis patients. Nephron Clin Pract 2012; 122: 127–133.
Garagarza C, João-Matias P, Sousa-Guerreiro C, Amaral T, Aires I, Ferreira C et al. Nutritional status and overhydration: can bioimpedance spectroscopy be useful in haemodialysis patients? Nefrologia 2013; 33: 667–674.
Daugirdas JT, Greene T, Rocco MV, Kaysen GA, Depner TA, Levin NW et alFHN Trial Group. Effect of frequent haemodialysis on residual kidney function. Kidney Int 2013; 83: 949–958.
Konings CJ, Kooman JP, Schonck M, van Kreel B, Heidendal GA, Cheriex EC et al. Influence of fluid status on techniques used to assess body composition in peritoneal dialysis patients. Perit Dial Int 2003; 23: 184–190.
Papakrivopoulou E, Booth J, Pinney J, Davenport A . Comparison of volume status in asymptomatic haemodialysis and peritoneal dialysis outpatients. Nephron Extra 2012; 2: 48–54.
Booth J, Pinney J, Davenport A . The effect of vascular access modality on changes in fluid content in the arms as determined by multifrequency bioimpedance. Nephrol Dial Transplant 2011; 26: 227–231.
Kumar S, Khosravi M, Massart A, Potluri M, Davenport A . Changes in upper limb extracellular water content during hemodialysis measured by multi-frequency bioimpedance. Int J Artif Organs 2013; 36: 203–207.
Chua HR, Xiang L, Chow PY, Xu H, Shen L, Lee E et al. Quantifying acute changes in volume and nutritional status during haemodialysis using bioimpedance analysis. Nephrology 2012; 17: 695–702.
Acknowledgements
This study was funded by the Royal Free Hospital.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Additional information
Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website
Supplementary information
Rights and permissions
About this article
Cite this article
Panorchan, K., Nongnuch, A., El-Kateb, S. et al. Changes in muscle and fat mass with haemodialysis detected by multi-frequency bioelectrical impedance analysis. Eur J Clin Nutr 69, 1109–1112 (2015). https://doi.org/10.1038/ejcn.2015.90
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ejcn.2015.90
- Springer Nature Limited
This article is cited by
-
Serum irisin levels are negatively associated with blood pressure in dialysis patients
Hypertension Research (2023)
-
Assessing lean tissue by bioelectrical impedance analysis pre hemodialysis underestimates the prevalence of sarcopenia in maintenance hemodialysis patients
European Journal of Clinical Nutrition (2021)
-
Sarcopenia in chronic kidney disease: what have we learned so far?
Journal of Nephrology (2021)
-
The effect of an arteriovenous fistula and haemodialysis on anthropometric measurements of the upper arm
European Journal of Clinical Nutrition (2020)
-
Patient-reported outcomes and objective assessments with arm measurement and bioimpedance analysis for lymphedema among breast cancer survivors
Breast Cancer Research and Treatment (2020)