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Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis

BACKGROUND: The number of elderly people on dialysis is increasing rapidly. Fluid overload and malnutrition status are serious problems in elderly dialysis patients. We aimed to compare the hydration and nutritional status through bioimpedance analysis (BIA) between young and elderly hemodialysis (H...

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Autores principales: Lee, Jung Eun, Jo, In Young, Lee, Song Mi, Kim, Woo Jeong, Choi, Hoon Young, Ha, Sung Kyu, Kim, Hyung Jong, Park, Hyeong Cheon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541557/
https://www.ncbi.nlm.nih.gov/pubmed/26316728
http://dx.doi.org/10.2147/CIA.S86229
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author Lee, Jung Eun
Jo, In Young
Lee, Song Mi
Kim, Woo Jeong
Choi, Hoon Young
Ha, Sung Kyu
Kim, Hyung Jong
Park, Hyeong Cheon
author_facet Lee, Jung Eun
Jo, In Young
Lee, Song Mi
Kim, Woo Jeong
Choi, Hoon Young
Ha, Sung Kyu
Kim, Hyung Jong
Park, Hyeong Cheon
author_sort Lee, Jung Eun
collection PubMed
description BACKGROUND: The number of elderly people on dialysis is increasing rapidly. Fluid overload and malnutrition status are serious problems in elderly dialysis patients. We aimed to compare the hydration and nutritional status through bioimpedance analysis (BIA) between young and elderly hemodialysis (HD) patients and to analyze risk factors related to fluid overload and malnutrition status in these patients. METHOD: We conducted a cross-sectional study, in which 82 HD (males 42, mean age 58.7±12.9 years) patients were enrolled. We collected different types of data: laboratory data, such as serum creatinine, albumin, total iron-binding capacity, hemoglobin, total cholesterol; anthropometric data, such as hand grip strength (HGS); BIA data, such as intracellular water, skeletal muscle mass, body cell mass, bone mineral content, phase angle (PhA), extra cellular water (ECW)/total body water (TBW) ratio; and malnutrition-inflammation score (MIS), which is a traditional nutritional parameter for dialysis patients. All patients were stratified into two groups according to their age: young (<65 years [n=54]) and elderly (≥65 years [n=28]). RESULTS: Total iron-binding capacity and HGS were significantly lower in elderly HD patients than in young HD patients (198.9±35.6 vs 221.4±52.1 mcg/dL; and 22.4±10.3 vs 36.4±23.2 kg, respectively) (P<0.05). Also, intracellular water and PhA measured by BIA were significantly lower (18.3±4.0 vs 20.3±4.2 L [P=0.043]; and 4.0±1.0 vs 4.9±1.2° [P=0.002], respectively), and ECW/TBW were higher in elderly HD patients (0.40±0.01 vs 0.39±0.01 [P=0.001]). ECW/TBW was positively associated with age (P<0.001) and the presence of diabetes (P<0.001) and was negatively associated with sex (P=0.001), albumin (P<0.001), urine volume (P=0.042), HGS (P<0.001), and PhA by BIA (P<0.001). MIS was negatively related to sex (P=0.001), albumin (P<0.001), HGS (P=0.001), and PhA (P<0.001) in HD patients. On multivariate analysis, older age (P=0.031), the presence of diabetes (P=0.035), and decreased PhA (P<0.001) were independent risk factors for increased ECW/TBW, representative of fluid overload status, whereas only decreased PhA (P=0.008) was a significant factor for MIS, representative of malnutrition status in these HD patients. CONCLUSION: We found that fluid overload and malnutrition status were more common in elderly HD patients compared with young HD patients. PhA was a significant independent factor in fluid overload status and malnutrition in these HD patients. Thus, our results indicated that PhA assessed by BIA might be a clinically useful method for assessing nutritional and hydration status in elderly HD patients.
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spelling pubmed-45415572015-08-27 Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis Lee, Jung Eun Jo, In Young Lee, Song Mi Kim, Woo Jeong Choi, Hoon Young Ha, Sung Kyu Kim, Hyung Jong Park, Hyeong Cheon Clin Interv Aging Original Research BACKGROUND: The number of elderly people on dialysis is increasing rapidly. Fluid overload and malnutrition status are serious problems in elderly dialysis patients. We aimed to compare the hydration and nutritional status through bioimpedance analysis (BIA) between young and elderly hemodialysis (HD) patients and to analyze risk factors related to fluid overload and malnutrition status in these patients. METHOD: We conducted a cross-sectional study, in which 82 HD (males 42, mean age 58.7±12.9 years) patients were enrolled. We collected different types of data: laboratory data, such as serum creatinine, albumin, total iron-binding capacity, hemoglobin, total cholesterol; anthropometric data, such as hand grip strength (HGS); BIA data, such as intracellular water, skeletal muscle mass, body cell mass, bone mineral content, phase angle (PhA), extra cellular water (ECW)/total body water (TBW) ratio; and malnutrition-inflammation score (MIS), which is a traditional nutritional parameter for dialysis patients. All patients were stratified into two groups according to their age: young (<65 years [n=54]) and elderly (≥65 years [n=28]). RESULTS: Total iron-binding capacity and HGS were significantly lower in elderly HD patients than in young HD patients (198.9±35.6 vs 221.4±52.1 mcg/dL; and 22.4±10.3 vs 36.4±23.2 kg, respectively) (P<0.05). Also, intracellular water and PhA measured by BIA were significantly lower (18.3±4.0 vs 20.3±4.2 L [P=0.043]; and 4.0±1.0 vs 4.9±1.2° [P=0.002], respectively), and ECW/TBW were higher in elderly HD patients (0.40±0.01 vs 0.39±0.01 [P=0.001]). ECW/TBW was positively associated with age (P<0.001) and the presence of diabetes (P<0.001) and was negatively associated with sex (P=0.001), albumin (P<0.001), urine volume (P=0.042), HGS (P<0.001), and PhA by BIA (P<0.001). MIS was negatively related to sex (P=0.001), albumin (P<0.001), HGS (P=0.001), and PhA (P<0.001) in HD patients. On multivariate analysis, older age (P=0.031), the presence of diabetes (P=0.035), and decreased PhA (P<0.001) were independent risk factors for increased ECW/TBW, representative of fluid overload status, whereas only decreased PhA (P=0.008) was a significant factor for MIS, representative of malnutrition status in these HD patients. CONCLUSION: We found that fluid overload and malnutrition status were more common in elderly HD patients compared with young HD patients. PhA was a significant independent factor in fluid overload status and malnutrition in these HD patients. Thus, our results indicated that PhA assessed by BIA might be a clinically useful method for assessing nutritional and hydration status in elderly HD patients. Dove Medical Press 2015-08-13 /pmc/articles/PMC4541557/ /pubmed/26316728 http://dx.doi.org/10.2147/CIA.S86229 Text en © 2015 Lee et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Lee, Jung Eun
Jo, In Young
Lee, Song Mi
Kim, Woo Jeong
Choi, Hoon Young
Ha, Sung Kyu
Kim, Hyung Jong
Park, Hyeong Cheon
Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis
title Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis
title_full Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis
title_fullStr Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis
title_full_unstemmed Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis
title_short Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis
title_sort comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541557/
https://www.ncbi.nlm.nih.gov/pubmed/26316728
http://dx.doi.org/10.2147/CIA.S86229
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