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Kidney Week

Abstract: SA-PO502

Using Segmental Bioelectrical Impedance Analysis to Predict Abdominal Cystic Organ Volumes in Autosomal Dominant Polycystic Kidney Disease

Session Information

  • ADPKD: Clinical Studies
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidney

  • 1001 Genetic Diseases of the Kidney: Cystic

Authors

  • Ryu, Hyunjin, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)
  • Kim, Hyunsuk, Chuncheon Sacred Heart Hospital, Chuncheon, Gangwon-Do, Korea (the Republic of)
  • Park, Hayne C., Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)
  • Oh, Yun Kyu, Department of Internal Medicine, Boramae Medical Center, Seoul, Korea (the Republic of)
Background

Increased abdominal cystic organ volume are risk factor for pressure-related complications and malnutrition in autosomal dominant polycystic kidney disease (ADPKD). However measuring actual abdominal cystic organ volume can be difficult in routine practice.
Bioelectrical impedance analysis (BIA) are non-invasive, easy-to-use tool which can be applied in outpatient clinic. In this study, we evaluated the association of segmental BIA parameters with abdominal cystic organ volume in ADPKD patients.

Methods

In this single center, cross-sectional study, segmental BIA (Inbody S10) were measured and height-adjusted total kidney and liver volume (htTKLV) were calculated using recent CT scan in all patients.

Results

A total of 288 patients were included in the study and 47.9% were female. The mean age was 48.3±12.2 years and the mean estimated glomerular filtration rate (eGFR) was 65.3±25.3 mL/min/1.73m2. The median values of htTKLV were 1,776 mL/m (IQR 1,361–2,381 mL/m). The highest correlation between BIA parameters and nature log value of htTKLV (ln htTKLV) was observed for the ratio of extracellular water to total body water (ECW/TBW) of trunk (ECW/TBWTR) (r=0.466), followed by whole-body (ECW/TBWWB) (r=0.407), lower extremity (ECW/TBWLE) (r=0.385), and phase angle of trunk (PhATR) (r=0.215). The phase angle of lower extremity (PhALE) correlated negatively with ln htTKLV (r=-0.279). To exclude the effect of renal function on BIA, the subgroup analysis of patients with eGFR ≥45 mL/min/1.73 m2 were conducted and correlations were similar. In the Receiver-operating characteristics analysis to predict the significant htTKLV (defined as ≥2,400 mL/m, the value known to increase 8.7 fold of malnutrition risk from previous study), ECW/TBWTR showed the largest area under curve (0.726) with the following order; ECW/TBWWB (0.697), ECW/TBWLE (0.683), PhALE (0.637) and PhATR (0.601). The cut off value of ECW/TBWTR to predict significant htTKLV was ≥0.387 with sensitivity of 57.7% and specificity of 76%.

Conclusion

Among segmental BIA parameters, ECW/TBWTR showed highest correlation with htTKLV. Using the cut off value of ECW/TBWTR ≥0.387, significant htTKLV values of ≥ 2,400 mL/m can be detected with sensitivity of 57.7% and specificity of 76%.