Resumo

DI-GIOIA, Mª Cristina et al. Changes in body composition parameters in patients on haemodialysis and peritoneal dialysis. Nefrología (Madr.) [online]. 2012, vol.32, n.1, pp.108-113. ISSN 1989-2284.

Introduction: Proper hydration is one of the major aims in haemodialysis (HD) and peritoneal dialysis (PD). Bioimpedance spectroscopy appears to be a promising method for the evaluation and follow up of the hydration status in dialysis patients (P). Objectives: We compared body composition between stable patients on HD and PD after six months. Patients and method: An observational study with 62 P on HD and 19 P on PD was performed. Clinical, biochemical and bioimpedance parameters were analysed. Results: In the comparative study, PD P were younger (50±10 vs 57±14 years, P=.031). The Charlson Comorbidity Index (4.8±3 vs 7.5±3, P<.001), time on dialysis (16.9±18.01 vs 51.88±68.79 months, P=.020) and C-Reactive Protein [3 (3-9.3) vs 5.25 (1-76.4)] were lower. Total protein levels (7.46±0.44 vs 7.04±0.55 g/dl, P=.005) and transferrin levels (205±41 vs 185±29 mg/dl, P=.024) were higher. BIS: Intracellular water (19.67±3.61 vs 16.51±3.36 litres, P=.010), lean tissue mass (LTM) (37.20±8.65 vs 32.57±8.72 kg, P=.029), total cellular mass (TCM) (20.53±5.65 vs 17.56±5.91 kg, P=.033), and bioelectrical impedance phase angle (Phi 50) (5.81±0.86 vs 4.74±0.98, P=.000) were higher than in HD P. Overhydration: 22% in HD y 10% in PD, in conditions referred to in methods. Six months later, PD P increased in weight (73.75±12.27 vs 75.22±11.87 kg, P=.027), total fat (FAT) (26.88±10 vs 30.02±10 kg, P=.011) and relative fat (Rel FAT) (35.75±9.87 vs 39.34±9.12, P=.010); and decreased in ICW (18.56±3.45 vs 17.65±3.69 l, P=.009), LTM (36.95±8.88 vs 34±9.70 kg, P=.008) and relative LTM (Rel LTM) (50.85±12.33 vs 45.40±11.95%, P=.012). In the multivariate analysis, weight variation (Δ) was related to Δ FAT (P<.001). We found a correlation between fat increase and lean tissue mass decrease. Six months later, in HD P, we observed a reduction in ECW (15.11±2.45 vs 14.00±2.45, P.001), without changes in other parameters. Conclusions: Bioelectrical impedance analysis facilitates the assessment of changes in body composition so as to correct dry weight and to introduce changes in treatment schedule.

Palavras-chave : Body composition; Overhydration; Haemodialysis; Peritoneal dialysis; Bioimpedance spectroscopy.

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