Kidney Week

Abstract: SA-PO1051

Efficacy of Segmental Bioelectrical Impedance Analysis in Regular Nutritional Assessment in Autosomal Dominant Polycystic Kidney Disease

Session Information

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

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Ryu, Hyunjin, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)

Hyunjin Ryu,

• Park, Hayne C., Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)

Hayne C. Park,

• Kim, Hyunsuk, Chuncheon Sacred Heart Hospital, Chuncheon, GANGWON-DO, Korea (the Republic of)

Hyunsuk Kim,

• Oh, Kook-Hwan, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)

Kook-Hwan Oh,

• Ahn, Curie, Seoul National University Hospital, JongNo-Gu, SEOUL, Korea (the Republic of)

Curie Ahn,

• Oh, Yun Kyu, Department of Internal Medicine, Boramae Medical Center, Seoul, Korea (the Republic of)

Yun Kyu Oh,

Background

Increased risk of malnutrition in autosomal dominant polycystic kidney disease (ADPKD) are found in patients with declined renal function and/or large abdominal cystic organ volume. Therefore regular nutritional assessment are important in ADPKD patients. Increased ratio of extracellular water to total body water (ECW/TBW) and decreased phase angle (PhA) are known malnutrition marker of bioelectrical impedance analysis (BIA). In this study, we analyzed the efficacy of BIA in the nutritional assessment follow-up compared to modified subjective global assessment (SGA) in ADPKD patients.

Methods

This is a prospective cohort study undertaken at a tertiary university hospital. Nutritional status were assessed with SGA and segmental BIA (Inbody S10) at the two visits of outpatient clinic between Dec. 2013 and Mar 2018. Height adjusted total kidney volume (htTKV) were calculated using ellipsoid method from CT scans of two visits.

Results

Total 135 patients were analyzed and 46.7% were female. At the initial visit, the mean age was 48.1±10.2 years and the mean eGFR was 62.8±21.7 mL/min/1.73m². The median values of htTKV were 801 mL/m (IQR 495–1185 mL/m). Interval between two visits were 28.5±4.4 month. Between two visits, eGFR decreased (62.8±21.7→56.4±23.5 mL/min/1.73m², p<0.001) and htTKV increased (927.4±627.8→1235.8±868.0 mL/m, p<0.001). However there were no statistical difference in SGA score (6.7±0.6→6.6±0.7), weight, body mass index, serum albumin, and cholesterol level during follow-up. Among the segmental BIA parameters, ECW/TBW of whole body (0.384±0.007→0.386±0.007, p<0.001), trunk (0.383±0.007→0.386±0.008, p<0.001) and lower extremity (0.387±0.008→0.388±0.008 p=0.015) increased significantly. The lean mass of whole body (48.4±10.67→47.8±10.6 p<0.001), upper extremity (2.7±0.8→2.6±0.8 p=0.007) and trunk (22.1±4.8→21.8±4.9 p=0.001) and PhA of upper extremity (5.3±0.6→5.1±0.7 p<0.001), trunk (9.0±1.4→7.8±1.2 p<0.001) and lower extremity (5.3±0.8→5.2±0.8, p<0.001) decreased significantly during the follow up.

Conclusion

Increased ECW/TBW level and decreased lean mass and PhA were found in ADPKD patients during follow up. Using quantitative parameters of segmental BIA, clinician were able to monitor nutritional status of ADPKD patients more sensitively, in addition to laboratory data and SGA.