engleski

THE USEFULNESS OF DXA AND LABORATORY PARAMETERS IN EVALUATION OF BODY COMPOSITION AND NUTRITIONAL STATUS IN MAN AND WOMAN ON MAINTANCE HAEMODIALYSIS

INTRODUCTION: About 30-70% patients on haemodialysis (HD) have mild to moderate malnutrition. It is very important to regularly assess the nutritional status in order to improve long-life survival as well as improve the quality of life in this population of patients. One of the methods to assess nutritional status is by dual energy X-ray absorptiometry (DXA). Namely, by DXA fat mass, lean soft-tissue mass and bone mineral content (BMC) could be measure. Therefore, the aim of our study was to investigate the usefulness of DXA and various laboratory parameters in assessment of nutritional status in men and women that are on maintained haemodialysis. PATIENTS AND METHODS: In this cross-sectional study we enrolled 133 patients mean age 56.4±12.3 years. All patients were dialyzed three times a week for 4 hours on biocompatible synthetic membranes for at least 6 months. Spent time on HD was 54.4±60.9 months. For this analysis purpose, patients were stratified into two groups according to the gender. The first group consistent of 62 (46.6%) female mean age 56.7±11.8 years and second group of 71 (53.4%) male mean age 56.2±12 years. For each patient serum albumin, cholesterol and C-reactive protein (CRP) were analyzed at the beginning of HD session. DXA and body mass index (BMI) were measured a day after HD session. DXA method was obtained by using Hologic Delphi apparatus. RESULTS: The mean BMI was 25±4.8 kg/m2 in woman and in man 25.1±3.3 kg/m2 (p=NS). According to DXA measurements in women, the mean lean mass was 43138.1±6436.8 g (65.9% total body), fat mass was 20549.4±7463 g (31.9% total body) and BMC was 1742.8±405.9 g (2.2% total body) respectively. Furthermore, the mean lean mass in men was 54606.8±4708.9 g (73% total body), fat mass 18680.3±6069.5 g (24% total body) and BMC was 2304±142.9 g (3% total body). Man had statistically significant higher values of BMC (p<0.0001) and lean values (p< 0.0001) while there was no statistically significant difference in the fat mass values between two groups of patients. Negative correlation between BMC and duration of HD (r= -0.326 ; p=0.01) in woman’s was observed, while there was no correlation between BMC and other parameters (CRP, serum albumins and cholesterol). Furthermore, fat in women showed positive correlation with BMI (r=0.292 ; p=0.02) and negative correlation with serum albumins (r=-0.318 ; p=0.01), while lean mass did not show any significant correlation with all investigated parameters. Analyzing the same parameters in man, we have found that BMC showed positive correlations with serum albumins (r=0.346 ; p=0.003) and BMI (r=0.313 ; p=0.008), while fat showed positive correlation only with BMI (r=0.755 ; p<0.0001) values. Furthermore, lean mass showed positive correlation with serum albumins (r=246 ; p=0.04) and BMI (r=0.627 ; p<0.001) values in man. CONCLUSION: BMI values and serum albumins levels showed the best aviability in both groups of patients and could be usefull parametars in evaluation of haemodialysis patients’ nutritional status.

haemodialysis; malnutrition; dual energy X-ray absorptiometry

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