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Total Body Water in Health and Disease: A Look at End-Stage Renal Disease

  • Luigi Vernaglione
  • Carlo Lomonte
  • Carlo Basile
Chapter

Abstract

Methods for determining body composition have improved over the past 20 years, greatly increasing the accuracy and ease of making these measurements. Body composition measurements may be useful in the clinical management of patients suffering from several diseases such as obesity, diabetes, metabolic syndrome and renal failure. The measurement of body composition may include direct or indirect measurements of total body water (TBW), body fat mass (FM), fat-free body mass (FFM) and bone mass, and sometimes of the distribution of fat between the visceral or subcutaneous compartments. The choice of method depends on which of these compartments is of interest, whether the measurement is for clinical purposes or research, and the degree of precision that is required. For the purposes of anthropometric measurement, for estimating adiposity, fat distribution and body composition, together with densitometry, isotope dilution, impedance measurement and imaging techniques are now available. For practical reasons, the direct measurement of body composition is essentially limited to research centres. For general uses, indirect methods of predicting body composition, such as the development of regression equations or the bioelectrical impedance analysis (BIA), have been based on anthropometric variables or electrical measurements. In the case of end-stage renal disease, TBW assessment by means of BIA has three main targets: (a) assessment of the body dry-weight; (b) evaluation of the nutritional status (considering TBW together with FM, FFM and body cell mass); (c) calculation of the dialysis adequacy. Currently available guidelines have underlined the need for sensitive measures of both nutritional and hydration status to prevent malnutrition and oedema in kidney patients; BIA represents an attractive clinical tool to detect early changes in body composition in this clinical setting.

Keywords

Body Composition Total Body Water Bioelectrical Impedance Analysis Body Cell Mass Skin Fold 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.

Abbreviations

BCM

Body cell mass

BIA

Bioelectrical impedance analysis

BMI

Body mass index

BW

Body weight

CT

Computed tomography

DEXA

Dual-energy absorptiometry

DW

Dry weight

ECW

Extracellular water

ESRD

End-stage renal disease

FFM

Fat-free mass

FM

Fat mass

H

Height

ICW

Intracellular water

MAC

Mid-arm circumference

MAMC

Mid-arm muscle circumference

MRI

Magnetic resonance imaging

NCDS

National Cooperative Dialysis Study

TBW

Total body water

TSF

Triceps skin fold

WHR

Waist-to-hip ratio

WHT

Ratio of waist circumference to the height

References

  1. Basile C, Vernaglione L, Di Iorio B, Bellizzi V, Chimienti D, Lomonte C, Rubino A, D’Ambrosio N. Clin J Am Soc Nephrol. 2007;2(4):675–80.PubMedCrossRefGoogle Scholar
  2. Basile C, Vernaglione L, Bellizzi V, Lomonte C, Rubino A, D’Ambrosio N, Di Iorio B. Nephrol Dial Transplant. 2008;23(6):1997–2002.PubMedCrossRefGoogle Scholar
  3. Basile C, Vernaglione L, Lomonte C, Bellizzi V, Dambrosio N, Di Iorio B. J Nephrol 2010;23:575–86.PubMedGoogle Scholar
  4. Bellizzi V, Scalfi L, Terracciano V, De Nicola L, Minutolo R, Marra M, Guida B, Cianciaruso B, Conte G, Di Iorio BR. J Am Soc Nephrol. 2006;17(5):1481–7.PubMedCrossRefGoogle Scholar
  5. Campanozzi A, Dabbas M, Ruiz JC, Ricour C, Goulet O. Eur J Pediatr. 2008;167(5):533–40.PubMedCrossRefGoogle Scholar
  6. Charra B, Laurent G, Chazot C, Calemard E, Terrat JC, Vanel T, Jean G, Ruffet M. Nephrol Dial Transplant. 1996;11(Suppl 2):S16–S19.CrossRefGoogle Scholar
  7. Chertow GM, Lazarus JM, Lew NL, Ma L, Lowrie EG. Kidney Int. 1997;51(5):1578–82.PubMedCrossRefGoogle Scholar
  8. Chumlea WC, Guo SS, Zeller CM, Reo NV, Baumgartner RN, Garry PJ, Wang J, Pierson RN Jr, Heymsfield SB, Siervogel RM. Kidney Int. 2001;59(6):2250–58.PubMedGoogle Scholar
  9. Daugirdas JT, Levin NW, Kotanko P, Depner TA, Kuhlmann MK, Chertow GM, Rocco MV. Seminars Dial. 2008;21:377–84.CrossRefGoogle Scholar
  10. Di Iorio BR, Scalfi L, Terracciano V, Bellizzi V. Kidney Int. 2004;65:2435–40.PubMedCrossRefGoogle Scholar
  11. Ellis KJ. Int J Obes Relat Metab Disord. 1996;20(9):866–73.PubMedGoogle Scholar
  12. Ellis KJ. Physiol Rev. 2000;80:649–80.PubMedGoogle Scholar
  13. Ellis KJ, Nichols BL Jr. Adv Pediatr. 1993;40:159–84.PubMedGoogle Scholar
  14. Fields DA, Higgins PB, Radley D. Curr Opin Clin Nutr Metab Care. 2005;8(6):624–9.PubMedCrossRefGoogle Scholar
  15. Frisancho AR. Am J Clin Nutr. 1981;34(11):2540–5.PubMedGoogle Scholar
  16. Hannan WJ, Cowen WJ, Fearon KCH, Plester CE, Falconer JS, Richardson RA. Clin Sci. 1994;86:479–85.PubMedGoogle Scholar
  17. Heymsfield SB, Wang Z, Baumgartner RN, Dilmanian FA, Ma R, Yasumura S. J Nutr. 1993;123(2 Suppl):432–7.PubMedGoogle Scholar
  18. Hoeffer EC, Meador CK, Simpson DC. J Appl Physiol. 1969;27:531–4.Google Scholar
  19. Hume R, Weyers E. J Clin Pathol. 1971;24:234–8.PubMedCrossRefGoogle Scholar
  20. Kahn HS, Imperatore G, Cheng YJ. J Pediatr. 2005;146(4):482–8.PubMedCrossRefGoogle Scholar
  21. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL. Adv Data. 2000;314:1–27.PubMedGoogle Scholar
  22. Kuczmarski RJ, Flegal KM, Johnson CL, Hubbard VS. Am J Clin Nutr. 2003;77:331–40.PubMedGoogle Scholar
  23. Kushner RF. J Am Coll Nutr. 1992;11(2):199–209.PubMedGoogle Scholar
  24. Lowrie EG, Lew NL. Am J Kidney Dis. 1990;15:458–82.PubMedGoogle Scholar
  25. Lukaski HC. J Nutr. 1993;123(2 Suppl):438–43.PubMedGoogle Scholar
  26. Mascarenhas MR, Zemel B, Stallings VA. Nutrition. 1998;14(1):105–15.PubMedCrossRefGoogle Scholar
  27. Maynard LM, Wisemandle W, Roche AF, Chumlea WC, Guo SS, Siervogel RM. Pediatrics. 2001;107(2):344–50.PubMedCrossRefGoogle Scholar
  28. Moore FD. The body cell mass and its supporting environment. Body composition in health and disease.Philadelphia, PA: WB Saunders; 1963.Google Scholar
  29. Moore FD, Lister J, Boyden CM, Ball MR, Sullivan N, Dagher FJ. Hum Biol. 1968;40(2):135–88.PubMedGoogle Scholar
  30. Piccoli A, for the Italian hemodialysis-bioelectrical impedance analysis (HD-BIA) study group. Kidney Int. 1998;53:1036–43.PubMedCrossRefGoogle Scholar
  31. Piccoli A, Nigrelli S, Caberlotto A, Bottazzo S, Rossi B, Pillon L, Maggiore Q. Am J Clin Nutr. 1995;61(2):269–70.PubMedGoogle Scholar
  32. Piccoli A, Brunani A, Savia G, Pillon L, Favaro E, Berselli ME, Cavagnini F. Int J Obes Relat Metab Disord. 1998;22(2):97–104.PubMedCrossRefGoogle Scholar
  33. Piccoli A, Pittoni G, Facco E. Crit Care Med. 2000;28(1):132–7.PubMedCrossRefGoogle Scholar
  34. Schoeller DA, van Santen E, Peterson DW, Dietz W, Jaspan J, Klein PD. Am J Clin Nutr. 1980;33(12):26862693.Google Scholar
  35. Segal KR, Lutin B, Presta E, Wang J, Van Itallie TB. J Appl Physiol. 1985;58:1565–71.PubMedGoogle Scholar
  36. Sun SS, Chumlea WC, Heymsfield SB, Lukaski HC, Schoeller D, Friedl K, Piccoli A, Rossi B, Pillon L, Bucciante G. Kidney Int. 1994;46(2):534–9.CrossRefGoogle Scholar
  37. Taksali SE, Caprio S, Dziura J, Dufour S, Calì AM, Goodman TR, Papademetris X, Burgert TS, Pierpont BM, Savoye M, Shaw M, Seyal AA, Weiss R. Diabetes. 2008;57(2):367–71.PubMedCrossRefGoogle Scholar
  38. Wang Z, Pierson RN, Heymsfield SB. Am J Clin Nutr. 1992;56:19–28.PubMedGoogle Scholar
  39. Watts K, Naylor LH, Davis EA, Jones TW, Beeson B, Bettenay F, Siafarikas A, Bell T, Ackland T, Green DJ. Med Sci Sports Excerc. 2006;38(3):439–44.CrossRefGoogle Scholar
  40. Watson PE, Watson ID, Batt RD. Am J Clin Nutr. 1980;33:27–39.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Nephrology and Dialysis Unit‘Miulli’ General HospitalTarantoItaly

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