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Kidney Week

Abstract: FR-PO893

Evaluation of Sex Difference in Fluid and Nutritional Statuses at the Initiation of Hemodialysis Using a New Bio-Impedance Spectroscopy Device

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Toida, Tatsunori, University of Miyazaki, Miyazaki, miyazaki, Japan
  • Fukunaga, Shin, Nobeoka Prefectural Hospital, Nobeoka, Miyazaki, Japan
  • Toida, Reiko, Chiyoda Hospital, Hyuga, Miyazaki, Japan
  • Uezono, Shigehiro, Chiyoda Hospital, Hyuga, Miyazaki, Japan
  • Nakagawa, Hideto, University of Miyazaki, Miyazaki, miyazaki, Japan
  • Sato, Yuji, University of Miyazaki, Miyazaki, miyazaki, Japan
  • Fujimoto, Shouichi, University of Miyazaki, Miyazaki, miyazaki, Japan
Background

Recently, the sex differences in health outcomes among patients undergoing maintenance dialysis were reported (JASN, 2017). The maintenance of an appropriate body fluid volume and nutritional status in hemodialysis patients is important for improving their prognoses. We herein cross-sectionally evaluated sex difference in over-hydration (OH) and the nutritional status (lean tissue index; LTI and skeletal muscle index; SMI) at the initiation of hemodialysis (HD) using a bio-impedance spectroscopy device (Body Composition Monitor, BCM).

Methods

119 patients at the initiation of hemodialysis (female vs. male, 49 vs. 70; mean age, 69.7 ± 11.2 years; mean BMI, 23.9 ± 4.5 kg/m2, 59 diabetic patients) were enrolled between February 2015 and December 2016 at Nobeoka Prefectural Hospital and Chiyoda Hospital. Measurements were performed before HD in the early phase after the initiation of HD by BCM and relationships between clinical data were also assessed. Furthermore, the nutritional statuses of HD patients in the present study were compared with our previous findings obtained in healthy Japanese volunteers (Biomed Mater Eng, 2015).

Results

Patients with diabetes or pleural effusion showed significantly higher OH levels compared to those without diabetes or pleural effusion. Serum NT-proBNP values and BMI were positively correlated with OH levels, respectively. OH level was not different between male and female.
LTI and SMI were negatively correlated with age in males, respectively, but not in females. LTI and SMI were not correlated with the levels of serum albumin or C-reactive protein. These indexes were not different between patients with or without diabetes. In males, LTI and SMI were lower in HD patients than in healthy volunteers, but not in females.

Conclusion

Present study suggests that BCM is a useful tool for evaluating the body fluid and nutritional status in patients at the initiation of HD. Furthermore, malnutrition is a concern in males at the initiation of HD. Follow-up observations using BCM may be useful for managing HD patients.