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Abstract: SA-PO830

Comparative Study on the Prognostic Value of Body Composition Parameters in Hospitalized Patients with Dialysis

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical

Authors

  • Mao, Huijuan, First Affiliated Hospital of Nanjing Medical University, Nanjing, JIANGSU , China
  • Wu, Buyun, Nanjing medical University, Nanjing City, JIANGSU , China
Background

Body composition is essential to the prognosis of dialysis patients, but comparison of prognostic value of different nutritional and fluid load parameters in the hospitalized patients with dialysis are limited.

Methods

We conducted a prospectively observational study to assess the association of different parameters in body composition with all-cause mortality in dialysis inpatients. The body composition was measured by bioelectrical impedance within the first 3 days after admission and hemodialysis patients should be measured before dialysis session. The parameters in fluid volume included overhydration (OH), the ratio of OH to extracellular water (OH/ECW), the ratio of extracellular water to body cell mass (ECW/BCM), the ratio of extracellular water to intracellular water (ECW/ICW); the parameters in nutritional status included fat tissue index (FTI), lean tissue index (LTI) and body cell mass index (BCMI).

Results

Of the 832 study patients, 191 (23.0%) died during a median follow-up of 31 months. In multivariable adjusted Cox models, higher ECW/BCM (adjusted hazard ratio per 1-SD, 1.30; 95% CI, 1.09 to 1.54) were associated with a significantly greater risk of death, as were lower LTI (adjusted odds ratio per 1-SD, 0.70; 95% CI, 0.59 to 0.83) and BCMI (adjusted hazard ratio per 1-SD, 0.72; 95% CI, 0.62 to 0.84). BMI, FTI and BCM/weight were also associated with death, but the magnitude of the association was greatest for ECW/BCM, LTI and BCMI. When ECW/BCM, LTI and BCMI were added to the fully adjusted model, only LTI improved the predictability for all-cause mortality (net reclassification index =0.15, P=0.04; integrated discrimination improvement =0.02, P=0.01).

Conclusion

ECW/BCM was the most relevant to mortality in fluid volume indices, and LTI and BCMI were most two relevant to mortality in nutritional status indices. Higher LTI was significantly associated with a lower risk of death and exhibited a stronger association with mortality than ECW/BCM, BCMI and other body composition parameters in dialysis inpatients.