Chronic Kidney Disease

CKD: Measuring Body Composition (2009)

• Assessment
  How are different methods for measuring body composition compared in CKD patients, and which method was the preferred one?

  • Conclusion

    Methods used to assess body composition in CKD patients include anthropometric measures, dual energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), creatinine kinetics (CK), and computed tomography (CT). Anthropometry and DXA are the two most often used methods in research studies but currently there is no reference standard for assessing body composition in CKD patients.

    Studies suggest that CKD patients exhibit altered body composition as compared to healthy individuals. These results do not show any one test is superior to another in assessing body composition among CKD patients.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: How are different methods for measuring body composition compared in CKD patients, and which method was the preferred one?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Avesani CM, Draibe SA, Kamimura MA, Cendoroglo M, Pedrosa A, Castro ML, Cuppari L.A. Assessment of body composition by dua energy X-ray absorptiometry, skinfold thickness and creatinine kinetics in chronic kidney disease patients. Neprhol Dial Transplant. 2004; 19: 2289-2295.
      • Barreto Silva MI, Avesani CM, Vale B, Lemos C, Bregman R. Agreement between anthropometry and bioelectrical impedance for measuring body fat in nonobese and obese nondialyzed chronic kidney disease patients. J Ren Nutr. 2008; 18(4): 355-362.
      • Bellizi V, Scalfi L, Terraciano V, De Nicola L, Minutolo R, Marra M, Guida B, Cianciaruso B, Conte G, Di Iorio BR. Early changes in bioelectrical estimates of body composition in chronic kidney disease. J Am Soc Nephrol. 2006; 17: 1481-1487.
      • Heimburger O, Quereshi AR, Blaner WS, Berglund L, Stenvinkel P.  Hand-grip muscle strength, lean body mass, and plasma proteins as markers of nutritional status in patients with chronic renal failure close to start of dialysis therapy. Am J Kidney Dis. 2000; 36(6): 1,213-1,225. 
      • Rigalleau V, Lasseur C, Chauveau P, Barthes N, Raffaitin C, Combe C, Perlemoine C, Baillet-Blanco L, Gin H. Body composition in diabetic subjects with chronic kidney disease: Interest of bio-impedance analysis, and anthropometry. Ann Nur Metab. 2004; 48: 409-413.
      • Sanches MR, Avesani CM, Kamimura MA, Lemaos MM, Axelsson J, Vasselai P, Draibe SA, Cuppari L. Waist circumference and visceral fat in CKD: A cross-sectional study. Am J Kidney Dis. 2008; 52: 66-73.
      • Woodrow G, Oldroyd B, Smith MA, Turney JH. Measurement of body composition in chronic renal failure: Comparison of skinfold anthropometrhy and bioelectrical impedance with dual energy X-ray absorptiometry. Eur J Clin Nutr. 1996; 50: 295-301.
  • Search Plan and Results: Comparisons of body composition measurements, 2009