Anthropometry and Body Composition in Chronic Kidney Disease Patients not on Dialysis

  • Vincenzo Bellizzi
  • Biagio Di Iorio
  • Luca Scalfi


Chronic Kidney Disease (CKD), characterized by complex metabolic derangements is burdened by changes in nutritional status during the entire course of the disease. Overt malnutrition is usually observed in the late stages of CKD, but a decrease of body cell mass and other changes in body composition, for instance over-hydration, may occur early, even with no evidence of weight loss. The effects of alteration in nutritional status and body composition on clinical outcome are critical; protein-energy wasting by itself can worsen renal function and prognosis, being also strictly related to cardiovascular risk. On the other hand, some studies, but not all, have indicated that in CKD patients not yet on dialysis there is an inverse relationship between higher body mass index and some hard outcomes, such as mortality and cardiovascular events. In addition, body mass index seems to be a predictor of the onset of CKD in the general population; a possible association with waist circumference or waist-to-hip ratio has been described, as well. Thus, a challenge for nutritionists and nephrologists is to identify early changes of nutritional status in CKD patients in order to improve the patient’s prognosis. International guidelines advise to assess nutritional status on a regular basis, but indications for CKD patients not yet on dialysis have been much less defined than those for dialysis patients. In addition, assessment of nutritional status in CKD requires multiple measurements and different techniques should be used concurrently. Anthropometry represents a first level assessment tool with some limitations because of the possible influence of an over-hydration state; although not very sensitive in detecting minor changes in body composition, it remains useful if associated with other nutritional tools. Among these, bioimpedance analysis (BIA) should be considered because it is very easy to perform at the bedside and can detect changes of body fluids in the early stages of CKD, such as blunted over-hydration in absence of clinically detectable edema. Thus, anthropometry and BIA should be used concurrently in the evaluation of nutritional status in CKD patients.


Chronic Kidney Disease Body Composition Chronic Kidney Disease Patient Chronic Kidney Disease Stage Skinfold Thickness 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Body cell mass


Bioimpedance analysis


Body mass index


Caring for Australian with Renal Impairment


Chronic kidney disease


Canadian Organ Replacement Registry


Computed tomography


Dual X-ray absorptiometry


Estimated GFR


End stage renal disease


European Best Practice Guidelines


Fat mass


Free-fat mass


Skinfold thickness


Glomerular filtration rate


Growth hormone


Heart rate


Kidney Disease: Improving Global Outcomes


Kidney/Disease Outcome Quality Initiative


Mid-arm circumference


Mid-arm muscle circumference


Phase angle


Prompt neutron activation analysis


Parathyroid hormone




Subjective global assessment


Total body water




Waist circumference


World Health Organization


Waist-to-hip ratio



We are in debt to the table study group (Prof. G. Conte, Prof. L. De Nicola, and Prof. R. Minutolo; Nephrology Division, Department of Gerontology, Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy) for providing us the database of CKD outpatients in the Italian tertiary nephrology care system which we used to obtain information on prevalence of overweight/obesity in chronic kidney disease.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Vincenzo Bellizzi
    • 1
  • Biagio Di Iorio
  • Luca Scalfi
  1. 1.Nephrology, Dialysis & Transplantation Unit, “San Giovanni di Dio e Ruggi d’Aragona”University Hospital, SalernoSalernoItaly

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