Comparison of Body Mass Index, Skinfold Thickness, and Bioelectrical Impedance Analysis With Dual‐Energy X‐Ray Absorptiometry in Hemodialysis Patients
2020
de Abreu, Aline Miroski | Wilvert, Luana Cristina | Wazlawik, Elisabeth
BACKGROUND: Malnutrition is a consistent finding in hemodialysis (HD) patients and is associated with high mortality. The aim was to compare nutrition status indicators using dual‐energy x‐ray absorptiometry (DXA) as reference in HD patients. METHODS: Observational cross‐sectional study with 42 patients, 55.8 years (±14.6) old, 60% male, HD 2–3 times per week for ≥3 months. HD ranged from 3 months to 28 years (median, 17.3; interquartile range, 8.73–39.0). We used body mass index (BMI) and fat mass (FM) by skinfold thickness (SFT), bioelectrical impedance analysis (BIA), and DXA. Statistical analyses used Bland‐Altman plots, Lin's concordance correlation coefficient, the paired t‐test, and Pearson or Spearman correlation. P < .05 was significant. RESULTS: SFT and DXA presented the lowest prevalence of malnutrition (2.4%) and BMI the highest (28.6%). BMI, BIA FM, and SFT FM presented strong positive correlations with DXA FM (r = 0.915; r = 0.976; r = 0.910, P < .001, respectively). BIA FM and fat‐free mass (FFM) demonstrated substantial agreement with DXA values (ρ = 0.974 and 0.960, P < .001). Thus, the measurement procedures used, SFT and BIA, underestimated %FM (−4.65% and −2.13%) and overestimated FFM (3.12 kg and 1.0 kg) according to DXA. No differences were found between mean values of BIA FM and DXA (P = .178). CONCLUSIONS: Compared with DXA, BIA was the most appropriate nutrition indicator for measuring body composition.
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