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American Society for Artificial Internal Organs, 43:251-255, 1997.
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Validation of body composition assessment techniques in the dialysis population.
Henry C. Lukaski.
Abstract: Estimation of body composition is an important component of human
nutritional assessment because it provides a measure of body energy stores.
Among healthy individuals, traditional approaches for estimating body fat
and lean tissue masses are commonly used. In patients with disrupted body
fluid and electrolyte balances and decreased bone mineral quality, these
traditional methods are not acceptable because the basic assumptions for the
methods are not valid in patient populations, particularly those patients
with chronic kidney disease that require dialysis. Increased body fluid
volumes result in increased values for skinfold thicknesses; bone loss
results in decreased bone mineral quality and decreased whole body density.
Some methods that can overcome these limitations include measurement of body
potassium with whole body counting of potassium-40, an index of body cell
mass, dual x-ray absorptiometry for determination of body fat, bioelectrical
impedance for assessment of fluid distribution. Routine assessment of body
composition in patients on long-term dialysis is needed to estimate the
amount of fluid to be removed during the dialysis treatment and to evaluate
the nutritional status (fat and lean components) of individuals with kidney
disease. This information will be useful to medical personnel and
nutritionists who provide medical care and nutritional support to patients
with chronic renal disease.
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