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Effect of peritoneal dialysate on bioelectrical impedance analysis variability in pediatric patients receiving peritoneal dialysis

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Abstract

Background

Previous adult studies have yielded conflicting results regarding whether the presence (D +) or absence (D-) of peritoneal dialysate affects the accuracy of bioelectrical impedance analysis (BIA) measurements. The aim of this study was to investigate whether the accuracy of BIA data varies between D + and D- measurements in children.

Methods

This cross-sectional study recruited chronic kidney disease stage 5 patients aged 3 to 18 years who received peritoneal dialysis. Body composition was assessed by multifrequency BIA, and values were compared between D + and D- measurements using the intraclass correlation coefficient (ICC).

Results

Fifty paired BIA measurements were collected from 18 patients with a mean age of 13.6 ± 4.1 years and a mean dialysate fill volume of 1,006 ± 239.7 ml/m2. Sixteen out of 17 BIA parameters (94.1%) exhibited excellent correlations between D + and D- measurements (ICC values = 0.954, 0.998). There was a trend of increased fluid status, including extracellular water, edema index, and overhydration, in D + measurements, with mean differences (95% CIs) of 0.5 (0.4, 0.6) L, 0.002 (0.001, 0.002), and 0.1 (0.1, 0.2) L, respectively. Soft lean mass and fat-free mass were higher in D + measurements, with mean differences (95% CIs) of 1.4 (1.2, 1.6), and 1.6 (1.4, 1.8) kg, respectively. In addition, patients older than 10 years had a stronger correlation between D + and D- measurements than younger patients.

Conclusions

A total of 94.1% of BIA parameters exhibited excellent correlations between D + and D- measurements, especially patients older than 10 years. We recommend that BIA measurements be collected from children regardless of the presence of peritoneal dialysate.

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Acknowledgements

The authors thank Miss Kwanjai Chotipanang, a medical scientist in the Division of Nutrition, Department of Pediatrics for her assistance with BIA measurements and Miss Maturin Juntongsree for her assistance with financial documentation.

Funding

This study was funded by the Research Department, Faculty of Medicine, Mahidol University, Bangkok, Thailand, grant number (IO) R016535033.

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Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Natthida Prukngampun, Anirut Pattaragarn, Achra Sumboonnanonda, Suroj Supavekin, Nuntawan Piyaphanee, Kraisoon Lomjansook, Yarnarin Thunsiribuddhichai & Thanaporn Chaiyapak

  2. Division of Nutrition, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Narumon Densupsoontorn

  3. Research Development Division, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Julaporn Pooliam

  4. Division of Pediatric Nursing, Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Intraparch Tinnabut

Authors
  1. Natthida Prukngampun
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  2. Narumon Densupsoontorn
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  6. Achra Sumboonnanonda
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  10. Yarnarin Thunsiribuddhichai
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  11. Thanaporn Chaiyapak
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Contributions

1. Natthida Prukngampun designed the study, collected the data, performed the analysis, interpreted the data, drafted the initial manuscript, and approved the final manuscript as submitted.

2. Narumon Densupsoontorn interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

3. Anirut Pattaragarn interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

4. Julaporn Pooliam performed the analysis, interpreted the data and approved the final manuscript as submitted.

5. Intraparch Tinnabut assisted with draining peritoneal dialysate, arranged for BIA measurements, and approved the final manuscript as submitted.

6. Achra Sumboonnanonda interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

7. Suroj Supavekin interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

8. Nuntawan Piyaphanee interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

9. Kraisoon Lomjansook interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

10. Yarnarin Thunsiribuddhichai interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

11. Thanaporn Chaiyapak made substantial contributions to the conception of the study, designed the study, interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Thanaporn Chaiyapak.

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Ethics approval

This study was approved by the Institutional Review Board of Siriraj Hospital.

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Informed consent and assent were obtained from all parents and participants, respectively.

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Not applicable.

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The authors declare no competing interests.

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Prukngampun, N., Densupsoontorn, N., Pattaragarn, A. et al. Effect of peritoneal dialysate on bioelectrical impedance analysis variability in pediatric patients receiving peritoneal dialysis. Pediatr Nephrol 39, 1499–1507 (2024). https://doi.org/10.1007/s00467-023-06219-y

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  • DOI: https://doi.org/10.1007/s00467-023-06219-y

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