Body Composition Analysis of Patients on Waiting List for Cadaveric Renal Transplantation: A Comparison of Hemodialysis and Peritoneal Dialysis Patients

作者：Bal Z; Uyar M E; Tutal E^*; Guliyev O; Sezer S; Haberal M

来源：Transplantation Proceedings, 2013, 45(10): 3489-3493.

DOI：10.1016/j.transproceed.2013.08.097

Background. Bioelectrical impedance analysis is a simple, noninvasive method of assessing body composition. Dialysis modality and selection of buffer type may have an impact on body composition. The aim of our study was to compare body compositions of patients from the waiting list for cadaveric renal transplantation according to the dialysis modality.
Methods. We examined a total of 152 (110 hemodialysis [HD] and 42 continuous ambulatory peritoneal dialysis [CAPD]) patients. Demographic data were collected from patient charts. The last 6 months routine laboratory evaluations including hemoglobin, serum creatinine, intact parathyroid hormone, albumin, C reactive protein, calcium, phosphorus were collected. Body compositions were measured using the Tanita BC-420MA Body Composition Analyzer (Tanita, Tokyo, Japan). We made a subanalysis of the CAPD group according to buffer choices as follows: lactate-buffered (n = 16) and bicarbonate/lactate buffered (n = 26) solution users.
Results. The body weight (P = .022), body mass index (BMI; 25.8 +/- 4.7 vs 23.4 +/- 4.9 kg/m(2), P = .009), muscle mass (P = .01), fat-free mass (P = .013), and visceral fat ratio (9.5 +/- 5.4 vs 7.3 +/- 4.1 %, P = .022) were significantly higher in the CAPD group. Total body water of CAPD patients were also higher (P = .003), but total body water ratios of HD and CAPD groups were similar. Fat and fat-free mass ratios of patient groups were also similar. Comparing CAPD subgroups we observed that patients using bicarbonate/lactate buffered solutions had higher body weights (P = .038), BMI (27.1 +/- 5 vs 23.7 +/- 3.5 kg/m(2), P = .018) values, and visceral fat ratios (8.0 +/- 5.2 vs 4.6 +/- 2.5 %, P = .023). These patients also tend to have higher fat mass without statistical significance (P = .074). Fat, muscle, and fat-free mass total body water ratios of peritoneal dialysis subgroups were similar.
Conclusion. We believe that body composition analysis should be used as a complementary method for assessing nutritional status of PD and CAPD patients as body weight or BMI measurements do not reflect fat, muscle masses, and visceral fat ratios in these patients. Stable, well nourished CAPD patients should be closely observed and be encouraged to increase daily exercise and/or decrease calorie intake from other sources to decrease risks associated with abdominal obesity.

• 出版日期2013-12