Abnormalities of Body Composition in Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Graham Woodrow ◽  
Brian Oldroyd ◽  
Antony Wright ◽  
W. Andrew Coward ◽  
John H. Turney ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Cell Mass ◽  
Body Water ◽  
Healthy Controls ◽  
Body Cell Mass ◽  
Extracellular Water ◽  
Body Cell ◽  
Nutrition And Hydration ◽  
Water Volumes ◽  
Total Body

Objectives Body composition changes occur in peritoneal dialysis (PD) due to abnormalities in nutrition and hydration. We investigated abnormalities of nutrition and hydration in PD patients compared with healthy controls by measurement of total body potassium (TBK) and body water compartments. Design Cross-sectional comparison study. Methods We measured TBK — an indicator of body cell mass — by whole body counting, total body water (TBW) by deuterium oxide dilution, and extracellular water (ECW) by bromide dilution in 29 PD patients and 32 controls. Results The absolute mean value of TBK for PD patients was not significantly lower than in controls. The ratios of observed TBK to predicted TBK from prediction formulas were compared. Equations used were those of Boddy, Bruce, Burkinshaw, and Ellis and our own equation derived from a local control database (Leeds). Observed/predicted ratios of TBK were significantly less in PD than in control subjects for all equations. Water volumes did not differ between PD and control groups. Observed/predicted ratios for TBK in PD patients correlated with serum potassium (Boddy r = 0.355, p = 0.06; Bruce r = 0.411, p < 0.05; Burkinshaw r = 0.457, p < 0.01; Leeds r = 0.412, p ≤ 0.05; Ellis r = 0.356, p = 0.06) and tended to correlate with serum albumin (Bruce r = 0.343, p = 0.07; Burkinshaw r = 0.421, p < 0.05; Leeds r = 0.357, p = 0.06; Ellis r = 0.310, p = NS). There was no relationship with serum potassium in controls. Serum albumin in PD correlated with TBK ( r = 0.445, p < 0.02), TBK/height ( r = 0.419, p < 0.05), TBK/weight ( r = 0.554, p = 0.002), and TBK/TBW ( r = 0.586, p = 0.0001). Extracellular water/intracellular water (ECW/ICW) was inversely related to TBK ( r = –0.455, p < 0.02 in PD; r = –0.387, p < 0.05 in controls) and to TBK/height ( r = –0.446, p < 0.02 in PD; r = –0.411, p = 0.02 in controls). TBK/weight reduced with age in PD ( r = –0.445, p < 0.02), as did TBK/TBW in PD ( r = –0.463, p < 0.02). ECW/ICW tended to increase with age in PD ( r = 0.351, p = 0.06). Conclusions Observed/predicted ratio of TBK is reduced in PD patients relative to healthy controls, indicating reduced body cell mass. Serum albumin and potassium reflect TBK indices in PD. Body water volumes did not differ between PD and controls, implying no overall abnormality in hydration in the PD group. However, ECW is relatively increased compared to ICW with decreasing TBK indices, suggesting relative ECW expansion with reduction in body cell mass.

A comparison of bioimpedance methods for detection of body cell mass change in HIV infection

2000 ◽  
Vol 88 (3) ◽  
pp. 944-956 ◽  
Author(s):  
Carrie P. Earthman ◽  
James R. Matthie ◽  
Phyllis M. Reid ◽  
Ingeborg T. Harper ◽  
Eric Ravussin ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cell Mass ◽  
Body Cell Mass ◽  
Extracellular Water ◽  
Multiple Frequency ◽  
Body Cell ◽  
Immunodeficiency Virus ◽  
Measuring Change ◽  
Before And After ◽  
Total Body

The maintenance of body cell mass (BCM) is critical for survival in human immunodeficiency virus (HIV) infection. Accuracy of bioimpedance for measuring change (Δ) in intracellular water (ICW), which defines BCM, is uncertain. To evaluate bioimpedance-estimated ΔBCM, the ICW of 21 weight-losing HIV patients was measured before and after anabolic steroid therapy by dilution (total body water by deuterium − extracellular water by bromide) and bioimpedance. Multiple-frequency modeling- and dilution-determined ΔICW did not differ. The ΔICW was predicted poorly by 50-kHz parallel reactance, 50-kHz impedance, and 200 − 5-kHz impedance. The ΔICW predicted by 500 − 5-kHz impedance was closer to, but statistically different from, dilution-determined ΔICW. However, the effect of random error on the measurement of systematic error in the 500 − 5-kHz method was 12–13% of the average measured ΔICW; this was nearly twice the percent difference between obtained and threshold statistics. Although the 500 − 5-kHz method cannot be fully rejected, these results support the conclusion that only the multiple-frequency modeling approach accurately monitors ΔBCM in HIV infection.

Total Body Water and Body Cell Mass in Normal Weight Healthy Adults

Nephron ◽  
2000 ◽  
Vol 86 (4) ◽  
pp. 531-533 ◽  
Author(s):  
Biagio Di Iorio ◽  
Vincenzo Terracciano ◽  
Vincenzo Bellizzi
Keyword(s):  
Total Body Water ◽  
Cell Mass ◽  
Normal Weight ◽  
Healthy Adults ◽  
Body Water ◽  
Body Cell Mass ◽  
Body Cell ◽  
Total Body

Predicting body cell mass with bioimpedance by using theoretical methods: a technological review

1997 ◽  
Vol 82 (5) ◽  
pp. 1542-1558 ◽  
Author(s):  
A. De Lorenzo ◽  
A. Andreoli ◽  
J. Matthie ◽  
P. Withers
Keyword(s):  
Deuterium Oxide ◽  
Cell Mass ◽  
Mixture Theory ◽  
The Body ◽  
Body Cell Mass ◽  
Extracellular Water ◽  
Theoretical Methods ◽  
Body Cell ◽  
Total Body ◽  
Cole Model

De Lorenzo, A., A. Andreoli, J. Matthie, and P. Withers.Predicting body cell mass with bioimpedance by using theoretical methods: a technological review. J. Appl. Physiol. 82(5): 1542–1558, 1997.—The body cell mass (BCM), defined as intracellular water (ICW), was estimated in 73 healthy men and women by total body potassium (TBK) and by bioimpedance spectroscopy (BIS). In 14 other subjects, extracellular water (ECW) and total body water (TBW) were measured by bromide dilution and deuterium oxide dilution, respectively. For all subjects, impedance spectral data were fit to the Cole model, and ECW and ICW volumes were predicted by using model electrical resistance terms RE and RI in an equation derived from Hanai mixture theory, respectively. The BIS ECW prediction bromide dilution was r = 0.91, standard error of the estimate (SEE) 0.90 liter. The BIS TBW prediction of deuterium space was r = 0.95, SEE 1.33 liters. The BIS ICW prediction of the dilution-determined ICW was r = 0.87, SEE 1.69 liters. The BIS ICW prediction of the TBK-determined ICW for the 73 subjects was r = 0.85, SEE = 2.22 liters. These results add further support to the validity of the Hanai theory, the equation used, and the conclusion that ECW and ICW volume can be predicted by an approach based solely on fundamental principles.

scholarly journals Using Dilution Techniques and Multifrequency Bioelectrical Impedance to Assess Both Total Body Water and Extracellular Water at Baseline and During Recombinant Human Growth Hormone (GH) Treatment in GH-Deficient Adults*

1997 ◽  
Vol 82 (10) ◽  
pp. 3349-3355 ◽  
Author(s):  
Y. J. H. Janssen ◽  
P. Deurenberg ◽  
F. Roelfsema
Keyword(s):  
Total Body Water ◽  
Water Distribution ◽  
Bioelectrical Impedance ◽  
Body Water ◽  
The Body ◽  
Healthy Controls ◽  
Extracellular Water ◽  
Gh Treatment ◽  
Total Body ◽  
Rhgh Treatment

Abstract Due to the use of various, and mostly indirect, methods to estimate total body water (TBW) and extracellular water (ECW), there is no agreement about whether body water distribution, i.e. the ECW to TBW ratio, is normal in GH-deficient (GHD) subjects at baseline and during recombinant human GH (rhGH) treatment. We studied body water distribution in 14 patients with adult-onset GHD and in 28 healthy controls. We also investigated the effect of GH replacement therapy for 4 and 52 weeks on body water distribution. All patients started with a dose of 0.6 IU rhGH/day for the first 4 weeks. After 52 weeks, the dose varied between 0.6–1.8 IU/day. TBW and ECW were measured by dilution of deuterium and bromide, respectively. Both parameters were also estimated using multifrequency bioelectrical impedance (BIA). Patients with GHD had significantly lower ECW and TBW than healthy controls. In addition, the ECW to TBW ratio was significantly lower in GHD patients than in healthy controls. Four weeks of GH treatment significantly increased body weight, TBW, ECW, and ECW/TBW. A further increase in TBW, but not ECW, was found after 52 weeks of treatment. The mean increases in TBW and ECW from the baselines were 2.5 ± 0.3 and 2.0 ± 0.3 L, respectively. The correlation coefficient and the estimated reliability between measured and estimated TBW and ECW at any time point were all high (&gt;0.91 and &gt;0.95, respectively). In general, both ECW and TBW were overestimated by multifrequency BIA in GHD adults. During treatment, the overestimation of both ECW and TBW diminished. The estimation error was correlated with the level of the body water compartment and the ratio of ECW to TBW. The estimated change in ECW with rhGH treatment was underestimated by multifrequency BIA. We conclude that GHD adults have lower ECW and TBW and a lower ECW to TBW ratio, as measured by dilution techniques. The ECW to TBW ratio can be normalized within 4 weeks of rhGH treatment at a dose of 0.6 IU/day. Finally, we conclude that multifrequency impedance measurements do not give valid estimates of body water compartments in the follow-up of patients with GHD.

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