A Comparative Study On Nutritional Status Of Hemodialysis Patients By Bioelectrical Impedance Analysis And Other Nutritional Evaluation Methods

Objective: Multi-methods comprehensive evaluation of nutritional status of maintenance hemodialysis(MHD)patients,to explore the effectiveness of bioelectrical impedance analysis(BIA)indicators for hemodialysis nutrition assessment and analysis of malnutrition-related factors.Methods: This study was an cross-sectional observational study.We used the bioelectrical impedance analysis(BIA),the modified quantitative subjective global assessment(MQSGA),body mass index(BMI)and synchronous laboratory tests to evaluate the nutritional status of patients with outpatient hemodialysis more than 3months in our hospital.Results: A total of 97 patients were enrolled in this study.The incidence of malnutrition was 57.732% by using MQSGA,the incidence of malnutrition was64.948% by using BCM(the main project of BIA),the incidence of malnutrition was65.979% by using BMI2(BMI<23kg/m2),the incidence of malnutrition is similar by using MQSGA,BCM and BMI2,there was no significant difference between any two methods(P>0.05).Patients were divided into non-edema group(ECW/TBW<0.39)and edema group(ECW/TBW?0.39)according to the edema index,intracellular body water(ICW),extracellular body water(ECW)and total body water(TBW)were not significantly different between the two groups(P>0.05);in the edema group,TBW increased only 1 person,19 normal,25 were reduced,there was a significant negative correlation between ECW/TBW and hemoglobin(HB),serum creatinine(SCr),uric acid(UA),albumin(ALB)and prealbumin(PALB)(P<0.05).There was a positive correlation between the phase angle(PA)and the HB,Cr,urea(BUN),UA,ALB,PALB and total body cells(BCM)(P<0.05),but negatively correlated with ECW/TBW and MQSGA(P<0.05).Multiple linear regression analysis showed that the MQSGA score was independently associated with PA(P=0.005),BMI(P=0.001),PALB(P=0.010)and dialysis age(P=0.000).PALB and SCr decreased with the increase of hs-CRP,however,BMI,body fat and percent body fat(PBF)increased with the increase of hs-CRP.Conclusion: Our study suggests that BCM,MQSGA and BMI2 can be used to evaluate the nutritional status of MHD,the incidence of malnutrition evaluated by MQSGA is similar to the ratio evaluated by BCM and BMI2.BCM and PA are closely related to the nutritional status of hemodialysis patients.PA,BMI,PALB and dialysis age are the independent influencing factors of nutritional status of MHD patients.Microinflammatory state is closely related to the nutritional status of hemodialysis patients.