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.

Predicted and Measured Daily Creatinine Production in CAPD: Identifying Noncompliance

1995 ◽  
Vol 15 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Karl D. Nolph ◽  
Zbylut J. Twardowski ◽  
Ramesh Khanna ◽  
Harold L. Moore ◽  
Barbara F. Prowant
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Lean Body Mass ◽  
Body Mass ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Albumin Concentration ◽  
Serum Albumin Concentration ◽  
Cross Sectional ◽  
Male Patients ◽  
Sectional Analysis

Objective To evaluate the ratio of measured creatinine (Cr) production to predicted creatinine production as an index of noncompliance in patients on continuous ambulatory peritoneal dialysis (CAPD). Design A cross-sectional analysis. Patients One hundred and twenty-one patients on CAPD. Measurements We have calculated Cr production from measured Cr outputs in 24-hour collections of urine and dialysate. Predicted Cr productions were calculated from standard tables. Weekly KTN urea and weekly Cr clearances were determined from the same 24-hour urine and dialysate collections. Lean body mass (LBM) was calculated from the Cr production. Serum albumin concentration was measured. Results The ratio of measured/predicted Cr production correlated positively and significantly with weekly KTN urea, the protein equivalent of nitrogen appearance (PNA), weekly Cr clearance, and LBM. There was a decline in serum albumin concentration at ratios greater than 1.24, supporting the opinions of previous authors who have suggested that ratios greater than 1.24 are highly suggestive of noncompliance with the dialysis prescription. Defining noncompliance as a ratio greater than 1.24 implied that at least 5% of the female and 17% of the male patients were noncompliant. Conclusions Declining serum albumin concentrations at higher ratios of measured/predicted Cr production support the opinion that this is an index of noncompliance. However, not all noncompliant patients necessarily have a ratio greater than 1.24. Weekly KTN urea, weekly Ccr and LBM are all artifactually increased by “washout effects” if all exchanges are done only or mainly on the collection day.

scholarly journals Lean Body Mass Predicts Long-Term Survival in Chinese Patients on Peritoneal Dialysis

PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e54976 ◽  
Author(s):  
Jenq-Wen Huang ◽  
Yu-Chung Lien ◽  
Hon-Yen Wu ◽  
Chung-Jen Yen ◽  
Chun-Chun Pan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Lean Body Mass ◽  
Body Mass ◽  
Chinese Patients ◽  
Term Survival ◽  
Long Term Survival

Cross Sectional Assessment of Weekly Urea and Creatinine Clearances and Indices of Nutrition in Continuous Ambulatory Peritoneal Dialysis Patients

1993 ◽  
Vol 13 (3) ◽  
pp. 178-183 ◽  
Author(s):  
Karl D. Nolph ◽  
Harold L. Moore ◽  
Barbara Prowant ◽  
Marianne Meyer ◽  
Zbylut J. Twardowski ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Lean Body Mass ◽  
Body Mass ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cross Sectional ◽  
Sectional Analysis ◽  
Net Protein ◽  
Small Solute

Objective To perform a cross sectional analysis in 71 patients on continuous ambulatory peritoneal dialysis (CAPD) to identify significant correlations of weekly small solute clearances and indices of nutritional status with each other and with patient demographics and other commonly monitored clinical and laboratory parameters. Design This was a retrospective, cross sectional analysis in 71 patients on CAPD from less than 1 to 105 patient-months (average, 20 months). Setting An outpatient CAPD program. Patients All patients on CAPD in our program at the time of the study willing to undergo the clearance and nutritional status measurements. Interventions No interventions other than the monitoring of their status. Main Outcome Measures Weekly small solute clearances, dietary protein intake, serum albumin, lean body mass, net protein catabolic rate, and urinary and dialysate nitrogen. Results Weekly K/V urea (weekly urea clearance normalized to total body water) of at least 1.7 and weekly total creatinine clearances (liter/week/1.7 m2) of at least 50 are associated with net protein catabolic rates (PCR) greater than 0.9 g/kg of normalized body weight in average CAPD patients. K/V urea and net PCR correlate significantly with serum albumin. High transporters identified by the peritoneal equilibration test have greater albumin losses and lower serum albumin concentrations. Estimates of lean body mass correlate significantly with serum albumin and net PCR; lean body mass correlates significantly and inversely with age. Conclusions Greater small solute clearances are associated with better nutritional status.

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.

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