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Abstract: TH-PO263

Reliability of Appendicular Muscle Mass Assessment by Bioelectrical Impedance Analysis vs. Dual-Energy X-Ray Absorptiometry in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Jung, Kwon soo, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Lee, Moon hyoung, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Park, Hae Yeul, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Choi, Hoon Young, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Kim, Hyunwook, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Park, Hyeong cheon, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
Background

Loss of skeletal muscle mass(MM) increases the risk for morbidity and mortality in hemodialysis (HD) patients. Dual energy X-ray absorptiometry (DXA) is a valid tool for assessing skeletal MM but limited by cost and radiation exposure. In contrast, bioelectrical impedance analysis (BIA) is cheap and has no radiation exposure risk. Aim of this study was to assess the concordance between MM measured by BIA and DXA in HD patients.

Methods

We enrolled 55 clinically stable HD patients. Body composition, including appendicular lean muscle mass (ALM), was evaluated by BIA (Inbody S10) and whole body DXA (HOLOGIC®). Hand grip strength (HGS) was performed to evaluate muscle performance. Agreement between tools was assessed by means of the Bland Altman method. Multiple linear regression was used to develop an ALM value by BIA closed to that by DXA.

Results

The mean age was 63.4±11.29 years (range 39 to 88 years) and 65.5% were men. The prevalence of diabetes and hypertension was 54.5% and 94.5%, respectively. There was a significant association between muscle mass index which determined via DXA and BIA. The mean value of ALM divided by the height2 (AMMI) was found to be 5.98±0.90 kg/m2 and 7.90 ±1.39 kg/m2 by DXA and by BIA, respectively, indicating overestimation of ALM in BIA method. BIA overestimated total body lean mass in 98% of participants. Bland-Altman plots for differences in AMMI between BIA and DXA showed large bias (Mean= 1.92kg/m2), with significant mean differences ([0.29, 3.55], P<0.001). After adjusting for sex, age and BMI, AMMI by BIA was significantly correlated with those measure by DXA (R2=0.643, P<0.001). Using the formula, we can estimate the AMMI by DXA with AMMI by BIA (DXA=0.859+0.452BIA+0.068BMI, R2=0.709, P<0.001). Mean HGS was 24.6±7.90 kg and AMMI showed no correlation with the HGS.

Conclusion

Our results showed that AMMI measured by BIA is reliable but overestimated in HD patients. Further reinfinement of adaptation formula for use BIA is needed to obtain accurate measurement of AMMI close to that measured by DXA.