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American Society for Artificial Internal Organs, 43:251-255, 1997.

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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