Nephrology Dialysis Transplantation, Vol 14, Issue 1 169-175, Copyright © 1999 by Oxford University Press
K Kalantar-Zadeh, E Dunne, K Nixon, K Kahn, G Lee, M Kleiner and F Luft
Background: malnutrition is a common problem in
dialysis patients and may affect up to one-third of patients. Near-infrared
interactance (NIR) is a novel approach to estimate body composition and per
cent total body fat. Methods: We used near-infrared
interactance (Futrex 5000®) to estimate the body composition
including body fat percentage, as well as subjective global assessment
(SGA), anthropometric measurements including mid-arm circumference (MAC),
triceps and biceps skinfold thickness, calculated mid-arm muscle
circumference (MAMC), body mass index (BMI), and laboratory values. NIR
score, SGA assessment and anthropometric parameters were measured shortly
after the end of a dialysis session. NIR measurement was made by placing a
Futrex® sensor on the non-access upper arm for several seconds.
Serum albumin, transferrin (reflected by total iron binding capacity), and
total cholesterol concentrations were performed as well.
Results: Thirty-four patients (20 men and 14 women)
were selected from a pool of 120 haemodialysis patients. Their ages ranged
from 26 to 86 years (58±14 years). Time on dialysis ranged from
8 months to 19 years (4.5±4.6 years). NIR scores were
significantly different in three SGA group: (A) well-nourished,
32.5±6.9%; (B) mildly to moderately malnourished,
29.2±5.3%; and severely malnourished, 23.2±10.2%
(P<0.001). Pearson correlation coefficients (r) between the NIR
score and nutritionally relevant parameters were significant
(P<0.001) for body mass index (r=+0.81), mid-arm circumference
(r=+0.74), triceps skin fold (r=+0.54), biceps skin fold (r=+0.55), and
mid-arm muscle circumference (r=+0.54). An inverse correlation was also
found between NIR and years dialysed (r=-0.49, P=0.004), denoting a lesser
body fat percentage according to NIR for patients dialysed longer. NIR was
correlated with serum transferrin (r=+0.41, P=0.016) and cholesterol
(r=+0.39, P=0.022) and marginally with serum albumin (r=+0.29, P=0.097).
Conclusions: We conclude that NIR, which can be
performed within seconds, may serve as an objective indicator of
nutritional status in haemodialysis patients. More comparative and
longitudinal studies are needed to confirm the validity of NIR measurements
in nutritional evaluation of dialysis patients. Key
words: albumin; anthropometric measurements; dialysis;
malnutrition; near-infrared (NIR); subjective global assessment (SGA);
transferrin
PRELIMINARY REPORTS
Near infra-red interactance for nutritional assessment of dialysis patients
UCSF Renal Division, San Francisco General Hospital, San Francisco, CA, USA; Department of Internal Medicine, Staten Island University Hospital, Staten Island, New York, USA; Franz Volhard Clinic, Universitatsklinikum-Charite, Humboldt University, Berlin, Germany; Corresponding author at: Franz Volhard Clinic, Wiltberg Strasse 50, 13122 Berlin, Germany
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