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



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.


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.



Body cell mass


Bioelectrical impedance analysis


Body mass index


Body weight


Computed tomography


Dual-energy absorptiometry


Dry weight


Extracellular water


End-stage renal disease


Fat-free mass


Fat mass




Intracellular water


Mid-arm circumference


Mid-arm muscle circumference


Magnetic resonance imaging


National Cooperative Dialysis Study


Total body water


Triceps skin fold


Waist-to-hip ratio


Ratio of waist circumference to the height


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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

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

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