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Malnutrition is frequent in end-stage renal disease patients treated by dialysis. Few data are available on the evaluation of nutritional status in chronic kidney disease (CKD) patients at different renal functional stage. The aim of this study was to evaluate the effect of the decreased renal function on body composition of CKD patients. To assess renal function, glomerular filtration rate (GFR) was measured as the renal clearance of 99mTc-DTPA in 1016 (533 males and 483 females) CKD patients. Body composition was evaluated by means of single-frequency bioimpedance analysis (BIA). Values of fat mass (FM), fat-free mass (FFM), body cell mass (BCM) and extra-cellular water (ECW) were indexed to squared height of patients, similarly to body mass index (BMI). BMI and FMI significantly increased with the reduction of GFR in females, while were unchanged in males. FFMI was unmodified independently from the gender. BCMI significantly decreased only in males, while was unmodified in females. Finally, ECWI significantly increased in all patients. These results indicate significant differences between male and female CKD patients, and in particular a different effect of decreased GFR on body mass and body composition in male and female patients. [ABSTRACT FROM AUTHOR]

In maintenance hemodialysis patients (MHD) analysis of body composition is a key point to assess nutritional status. Dual-energy X-ray absorptiometry (DXA) is a reference method for a detailed assessment of fat mass (FM) and lean body mass (LBM). The reliability of single-frequency bioelectrical impedance (sf-BIA) versus multi-frequency (mf- BIA) to analyze body composition in MHD is debated. Aim: to evaluate the adequacy of sf-BIA and mf-BIA, in comparison with DXA, to evaluate LBM in MHD patients. Patients (9 f, 18 m), 32-88 yrs, BW 42-94 kg, BMI 17.5-34.4 kg/m2, on MHD since 0.5-17.4 years. LBM was measured, in the interdialytic period, with DXA and BIA,with 2 sf-BIA and with 1 mf-BIA analyzer. A very close correlation was found between LBMBIA and LBM-DXA (R 0.901 - 0.921). Mean values of LBM were very similar with the different techniques. LBM was 45.1.1±8.8 kg (DXA); 45.1±8.5 (sf1-BIA); 45.8±8.8 (sf2-BIA); 44.4±11.5 (mf-BIA). Prediction errors were 3.4 kg for sf1-BIA, 4.0 kg for sf2-BIA, and 5.0 kg for mf-BIA. In conclusion, BIA is a reliable method to evaluate lean body mass in MHD. [ABSTRACT FROM AUTHOR]