Nephrology Dialysis Transplantation, Vol 12, Issue 1 151-156, Copyright © 1997 by Oxford University Press
W de Fijter, C de Fijter, P Oe, P ter Wee and A Donker
Background. Indirect methods such as anthropometry
(A), Watson formula (W), creatinine kinetics (CK), and body electrical
impedance (BEI) are increasingly applied to determine total body water
(TBW) and lean body mass (LBM) in dialysis patients. These methods share
the disadvantage that they have been validated for healthy men only. We
studied which of these four commonly applied methods can best be used
routinely in CAPD patients. Methods. TBW estimates
obtained from A, W, CK, and BEI were compared with those obtained by a gold
standard (antypirine distribution volume, ADV) in eight CAPD patients. In
addition, several BEI equations to derive lean body mass (LBM) were
compared with LBM estimated by ADV in order to determine which equation is
the most valuable for the assessment of LBM by BEI in CAPD patients.
Results. TBW as ADV was 41.4±6.6
(mean±SD) L. TBW estimated by W, A and CK underestimated ADV by
a mean±SD of 2.3±13, 5±8.4 and
12.3±10.9% respectively. TBW as measured by BEI overestimated
ADV by 2.5±8.8%. The correlation coefficients between ADV-TBW
and TBW estimated by the indirect methods were r=0.88 (A), r=0.87 (BEI),
r=0.82 (CK), and 0.68 (W). LBM estimated by ADV was 56.7±8.9
(mean±SD) kg; LBM by different BEI equations ranged from
49.9±7 to 58.1±10.7 kg. The correlation coefficient
between LBM by ADV and LBM according to the various BEI equations ranged
from 0.81 to 0.93. Conclusions. A and BEI: can be used
to estimate TBW, but the considerable SD (or inaccuracy) makes individual
predictions hazardous. Considering the correlation coefficients and
difference between LBM by ADV and LBM according to different BEI equations,
Deurenberg's formula can be advocated for use in the estimation of LBM by
BEI. Keywords: antipyrine kinetics; CAPD; lean body
mass; indirect methods; total body water
ORIGINAL ARTICLES
Assessment of total body water and lean body mass from anthropometry, Watson formula, creatinine kinetics, and body electrical impedance compared with antipyrine kinetics in peritoneal dialysis patients
Renal Unit, Department of Internal Medicine, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, The Netherlands; Corresponding author
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