P735 - INTEGRATING BIOELECTRICAL IMPEDANCE ANALYSIS (BIA) AND ESTIMATED GLOMERULAR FILTRATION RATE (EGFR): A NOVEL APPROACH TO ASSESSMENT OF NUTRITIONAL STATUS OF HEMODIALYSIS PATIENTS

P735

INTEGRATING BIOELECTRICAL IMPEDANCE ANALYSIS (BIA) AND ESTIMATED GLOMERULAR FILTRATION RATE (EGFR): A NOVEL APPROACH TO ASSESSMENT OF NUTRITIONAL STATUS OF HEMODIALYSIS PATIENTS

A. Basit^1,*, A. Forbes¹, K. Kõlvald²

¹University of Tartu, ²University of Tartu Hospital, Tartu, Estonia

Rationale: Haemodialysis (HD) patients have a high prevalence of malnutrition which worsens prognosis, but identification from nutrition screening is confounded by fluid retention and diagnosis is often late. Estimated Glomerular Filtration Rate (eGFR) indicates renal status, and it is proposed that its integration with Bioelectrical Impedance Analysis (BIA) parameters could better identify the patient's nutrition status and overall prognosis. 

Methods: 25 adults undergoing HD for at least 6 months were recruited. BIA was conducted pre-dialysis and contemporary eGFR was recorded. BIA parameters included the Fat-Free Mass Index (FFMI), and Body Fat Mass Index (BFMI), which were standardized using T-scores; the ratio of Extracellular Water (ECW) to Total Body Water (TBW) and phase angle (PhA) were considered markers of malnutrition. 

Results: Pearson correlation analysis suggested an inverse relationship between eGFR and PhA (r =-0.354, p =0.082). The mean eGFR was 6.80 (SD±2.14) and the mean PhA was 1.83 (SD±4.37). Based on a PhA threshold of <4.0°, 64% of patients were at risk of malnutrition. A possible negative correlation was found between the ECW/TBW ratio and PhA (r=–0.316, p=0.124). The BFMI and FFMI T-scores had non-significant relationships with eGFR. A possible positive correlation was found between PhA and FFMI T-Score (r=0.373, p=0.066).

Conclusion: Our results are suggestive of clinically useful correlations, but conclusions are limited by the small sample size. Larger longitudinal studies do however appear justified in order to validate the relationships between body composition and eGFR. BIA data indicate that a low PhA with a high ECW/TBW ratio is predictive of malnutrition in patients on HD and that higher fat-free mass is associated with better cellular health.  These observations are likely to be of prognostic value.

Disclosure of Interest: None declared