A multicentric, international matched pair analysis of body composition in peritoneal dialysis versus haemodialysis patients

Nephrol Dial Transplant. 2013 Oct;28(10):2620-8. doi: 10.1093/ndt/gft296.

Abstract

Background: Volume status, lean and fat tissue are gaining interest as prognostic predictors in patients on dialysis. Comparative data in peritoneal dialysis (PD) versus haemodialysis (HD) patients are lacking.

Methods: In a cohort of PD (EuroBCM) and HD (Euclid database) patients, matched for country, gender, age and dialysis vintage, body composition was assessed by bioimpedance spectroscopy (BCM, Fresenius Medical Care). Time-averaged volume overload (TAVO) was defined as the mean of pre- and post-dialysis volume overload (VO), and relative (%) (TA)VO as (TA)VO/ECV.

Results: Four hundred and ninety-one matched pairs (55.2% males, median age 60.0 years) were included. The body mass index (BMI, PD = 26.5 ± 4.7 versus HD = 25.9 ± 4.6 kg/m(2), P = 0.18 in males and 27.4 ± 5.8 versus 27.5 ± 6.6 kg/m(2), P = 0.75 in females) and fat tissue index (males: 11.5 ± 5.3 versus 11.4 ± 5.4 kg/m(2), P = 0.90, females: 14.8 ± 6.7 versus 15.4 ± 7.2 kg/m(2), P = 0.30) were not different in PD versus HD patients, whereas the lean tissue index (LTI) was higher in PD versus HD patients (males: 14.5 ± 3.4 versus 13.7 ± 3.1 kg/m(2), P = 0.001, females: 12.6 ± 3.3 versus 11.5 ± 2.6 kg/m(2), P < 0.0001). VO/extracellular water (ECW) was not different between PD versus just before the HD treatment (males: 10.8 ± 12.1 versus 9.2 ± 10.2%, P = 0.09; females: 6.5 ± 10.8 versus 7.7 ± 9.4%, P = 0.19). The relative TAVO was higher in PD versus HD (10.8 ± 12.1% versus 3.2 ± 11.2%, and 6.5 ± 10.8% versus 1.2 ± 10.9%, both P < 0.0001).

Conclusions: The LTI was impaired, and this was more in males versus females, but was better preserved on PD versus HD, whereas fat tissue index (FTI) was increased, but not different between PD and HD. Volume overload was more present in PD versus HD when TAVO, but not when predialysis volume status, was used as a reference.

Keywords: bioimpedance; body composition; haemodialysis; peritoneal dialysis; volume status.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adipose Tissue
  • Body Composition*
  • Body Mass Index
  • Body Water
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • International Agencies
  • Kidney Diseases / therapy*
  • Kidney Function Tests
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Multivariate Analysis
  • Peritoneal Dialysis*
  • Prognosis
  • Renal Dialysis*