Sources of Variation in Estimates of Lean Body Mass by Creatinine Kinetics and by Methods Based on Body Water or Body Mass Index in Patients on Continuous Peritoneal Dialysis

2010 ◽  
Vol 20 (2) ◽  
pp. 91-100 ◽  
Author(s):  
Antonios H. Tzamaloukas ◽  
Glen H. Murata ◽  
Beth Piraino ◽  
Dominic S.C. Raj ◽  
Dorothy J. VanderJagt ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Peritoneal Dialysis ◽  
Lean Body Mass ◽  
Body Mass ◽  
Body Water ◽  
Sources Of Variation ◽  
Creatinine Kinetics ◽  
Continuous Peritoneal Dialysis

The Role of Lean Body Mass as a Nutritional Index in Chinese Peritoneal Dialysis Patients—Comparison of Creatinine Kinetics Method and Anthropometric Method

2000 ◽  
Vol 20 (6) ◽  
pp. 708-714 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Johnathan Kong ◽  
Alan K.L. Wu ◽  
Teresa Y.H. Wong ◽  
Angela Y.M. Wang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Lean Body Mass ◽  
Body Mass ◽  
Chinese Patients ◽  
Nutritional Indices ◽  
Protein Nitrogen ◽  
Creatinine Kinetics ◽  
The Mean ◽  
The Difference

Objective To compare, in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients, the creatinine kinetics method (LBM-CK) and the anthropometric method (LBM-AM) for determining lean body mass (LBM). Design Single-center cross-sectional study. Patients and Methods We studied 151 unselected CAPD patients (78 males, 73 females). We calculated LBM-CK and LBM-AM using standard formulas. The results of the two methods were then compared by the Bland and Altman method. Dialysis adequacy and other nutritional indices, including total Kt/V, weekly creatinine clearance (CCr), residual glomerular filtration rate (GFR), protein nitrogen appearance (PNA), subjective global assessment (SGA), and serum albumin, were measured simultaneously. Results The mean age of the patients was 55.6 ± 12.2 years, and the mean duration of dialysis was 33.6 ± 28.5 months. The mean body mass index (BMI) was 22.7 ± 3.7. The average LBM-AM was 43.6 ± 8.0 kg; the average LBM-CK was 33.0 ± 9.3 kg. The difference between the calculated LBM-AM and LBM-CK was 10.7 kg, with LBM-AM always giving a higher value; the limits of agreement were –5.8 kg and 27.1 kg. The difference between the two measures correlated with residual GFR (Pearson r = 0.629, p < 0.001). After normalizing for desired body weight, LBM-AM was only modestly correlated with serum albumin level. No correlations were found between overall SGA score or normalized protein nitrogen appearance (nPNA) and LBM-AM or LBM-CK. Conclusions In Chinese patients at least, a substantial discrepancy exists between LBM-AM and LBM-CK. The difference is especially marked in patients with significant residual renal function. The optimal method for determining LBM remains obscure in Chinese CAPD patients. Moreover, LBM correlated poorly with other nutritional indices. Multiple parameters should be taken into consideration in an assessment of nutritional status of CAPD patients.

scholarly journals Association of Lean Body Mass Index and Peritoneal Protein Clearance in Peritoneal Dialysis Patients

2019 ◽  
Vol 44 (1) ◽  
pp. 94-102 ◽  
Author(s):  
Jinjin  Fan ◽  
Hongjian  Ye ◽  
Xiaodan  Zhang ◽  
Peiyi  Cao ◽  
Qunying  Guo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Lean Body Mass ◽  
Body Mass ◽  
Creatinine Ratio ◽  
Protein Loss ◽  
Protein Clearance ◽  
The Relationship ◽  
Peritoneal Protein Clearance

Background/Aims: The relationship between peritoneal protein clearance (PPCl) and nutritional status in peritoneal dialysis (PD) population have not been clarified. This study aims to investigate the relationship between PPCl and nutritional status in PD population. Methods: Prevalent PD patients were enrolled in the cross-sectional survey in a single center from April to November 2013. The total amount of protein loss in the dialysate was calculated. PPCl reflects the individual differences of peritoneal protein loss, and is calculated by the formula, that PPCl (ml/day)=24-h dialysate protein loss / (albumin/0.4783). Nutritional status measured by lean body mass index (LBMI) was assessed by multi-frequency bioelectrical impedance analysis (BIA). Results: Totally 351 PD patients (55% male, 17.1% with diabetes, mean age 47.7±14.3 years) were included. The median PPC l was 58 ml/day. Patients were divided into four groups for comparison according to the PPC quartiles. Compared with lower PPCl quartiles, patients with higher PPCl had higher body mass index (BMI) (P< 0.001), body surface area (BSA) (P < 0 .001), LBMI (P<0.001), 4-hour D/P creatinine ratio (P< 0.001), and lower residual renal CCl (P<0.001). Compared with conventional body index (BMI and BSA) in ROC analysis, LBMI (area under curve: 0.71, 95% confidence interval [CI]: 0.66-0.77) had better performance in predicting higher PPCl. After adjustment in logistic regression models, each 1 kg/m2 increase of LBMI (odd ratio[OR] =1.37; 95% CI: 1.17-1.60), each 0.1 increase of 4-hour D/P creatinine ratio (OR =1.47; 95% CI: 1.11-1.93), and every 1 L/week/1.73m2 decrease of residual renal CCl (OR =0.98; 95% CI: 0.96-0.99) were independently associated with higher PPCl (> 58 ml/day). Conclusion: Higher LBMI was independently associated with higher , indicating that better nutritional status dominates peritoneal protein metabolism in PD patients.

scholarly journals Novel Equations for Estimating Lean Body Mass in Peritoneal Dialysis Patients

2015 ◽  
Vol 35 (7) ◽  
pp. 743-752 ◽  
Author(s):  
Jie Dong ◽  
Yan-Jun Li ◽  
Rong Xu ◽  
Zhi-Kai Yang ◽  
Ying-Dong Zheng
Keyword(s):  
Peritoneal Dialysis ◽  
Lean Body Mass ◽  
Body Mass ◽  
Mortality Risk ◽  
Surrogate Markers ◽  
X Ray ◽  
Hand Grip ◽  
Accuracy And Precision ◽  
All Cause Mortality ◽  
Creatinine Kinetics

ObjectivesTo develop and validate equations for estimating lean body mass (LBM) in peritoneal dialysis (PD) patients.MethodsTwo equations for estimating LBM, one based on mid-arm muscle circumference (MAMC) and hand grip strength (HGS), i.e., LBM-M-H, and the other based on HGS, i.e., LBM-H, were developed and validated with LBM obtained by dual-energy X-ray absorptiometry (DEXA). The developed equations were compared to LBM estimated from creatinine kinetics (LBM-CK) and anthropometry (LBM-A) in terms of bias, precision, and accuracy. The prognostic values of LBM estimated from the equations in all-cause mortality risk were assessed.ResultsThe developed equations incorporated gender, height, weight, and dialysis duration. Compared to LBM-DEXA, the bias of the developed equations was lower than that of LBM-CK and LBM-A. Additionally, LBM-M-H and LBM-H had better accuracy and precision. The prognostic values of LBM in all-cause mortality risk based on LBM-M-H, LBM-H, LBM-CK, and LBM-A were similar.ConclusionsLean body mass estimated by the new equations based on MAMC and HGS was correlated with LBM obtained by DEXA and may serve as practical surrogate markers of LBM in PD patients.

scholarly journals Effects of Exercise Interventions on Weight, Body Mass Index, Lean Body Mass and Accumulated Visceral Fat in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 18 (5) ◽  
pp. 2635
Author(s):  
Hyun Suk Lee ◽  
Junga Lee
Keyword(s):  
Body Mass Index ◽  
Randomized Controlled Trials ◽  
Lean Body Mass ◽  
Body Mass ◽  
Visceral Fat ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Randomized Controlled

(1) Background: Exercise interventions for overweight and obese individuals help reduce accumulated visceral fat, which is an indicator of cardiometabolic risk, but the effectiveness of these interventions is controversial. The purpose of this meta-analysis was to investigate the effectiveness of exercise interventions in overweight and obese individuals in order to reduce weight, body mass index (BMI), and accumulated visceral fat, and increase lean body mass. (2) Methods: Databases were used to select eligible studies for this meta-analysis. Randomized controlled trials with control and experimental groups were included. The degrees of effectiveness of the exercise interventions were computed to assess the benefits on reducing weight, BMI, and accumulated visceral fat, and increasing lean body mass. (3) Results: Sixteen studies were included in this meta-analysis. Participation in exercise interventions reduced weight (d = −0.58 (95% confidence interval (CI), −0.84–−0.31; p < 0.001; k = 9)), BMI (d = −0.50 (95% CI, −0.78–−0.21; p < 0.001; k = 7)), and accumulated visceral fat (d = −1.08 (95% CI, −1.60–−0.57; p < 0.001; k = 5)), but did not significantly increase lean body mass (d = 0.26 (95% CI, −0.11–0.63; p = 0.17; k = 6)). The average exercise intervention for overweight and obese individuals was of moderate to vigorous intensity, 4 times per week, 50 min per session, and 22 weeks duration. (4) Conclusions: Participating in exercise interventions has favorable effects on weight, BMI, and accumulated visceral fat. Further studies considering different modalities, intensities, durations, and measurements of fatness need to be conducted.

Is Subjective Global Assessment a Good Index of Nutrition in Peritoneal Dialysis Patients with Gastrointestinal Symptoms?

2009 ◽  
Vol 29 (2_suppl) ◽  
pp. 78-82 ◽  
Author(s):  
Yanjun Li ◽  
Jie Dong ◽  
Li Zuo
Keyword(s):  
Peritoneal Dialysis ◽  
Lean Body Mass ◽  
Body Mass ◽  
Global Assessment ◽  
Handgrip Strength ◽  
Subjective Global Assessment ◽  
Gi Symptoms ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective We investigated whether patients with gastrointestinal (GI) symptoms were prone to be diagnosed as malnourished by subjective global assessment (SGA) by simultaneously evaluating SGA and other indices of nutrition in a cross-sectional survey of peritoneal dialysis (PD) patients. Patients and Method From June 2006 to June 2007, 214 PD patients were involved in the study. We recorded results of a GI symptoms questionnaire (GSQ) and SGA. Other indices of nutrition included dietary intake, chemistry examination, anthropometry, handgrip strength, and lean body mass measured by creatinine kinetics. Results Mean age of the 214 PD patients enrolled in the study was 60.22 ± 14.02 years, and mean dialysis duration was 60.22 ± 14.02 months. Of the 214 patients, 56 (27.16%) were diagnosed as malnourished by SGA. The mean GSQ scores were 9.37 ± 1.71 (range: 8 – 17). There were 90 patients with GSQ scores of 8 (group 1), 80 patients with scores of 9 or 10 (group 2), 44 patients with scores of 11 or more (group 3). The prevalence of malnutrition diagnosed by SGA was significantly different in the three groups: 15.56% in group 1, 27.5% in group 2, and 45.45% in group 3 ( p = 0.02). However, we observed no difference between the three groups in mid-arm circumference, skinfold thickness (biceps, triceps, subscapular, and suprailiac), daily protein and energy intake, handgrip strength, lean body mass, and serum albumin and prealbumin levels ( p > 0.05). Conclusions Our results showed that the reliability of SGA in PD patients with GI symptoms remains worth exploring. These patients are possibly diagnosed as malnourished by SGA, although many other indices of nutrition are not necessarily bad.

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