Combined assessment of nutritional status in patients with peritoneal dialysis using bioelectrical impedance vectors and malnutrition inflammation score.

BACKGROUND AND OBJECTIVE: Protein energy wasting (PEW) is a common syndrome in patients with chronic kidney disease, related to changes in hydration status, decreased food intake and inflammation. There are several tools for the assessment and diagnosis of such alterations. Bioimpedance vector analysis (BIVA) assess the state of nutrition and hydration, but not the inflammatory component, while the malnutrition inflammation score (MIS) comprises the inflammatory and nutritional factors, but not the state of hydration. The aim of the study was to determine the concordance between MIS and BIVA to assess nutritional status in peritoneal dialysis patients. METHODS: We studied 50 patients on peritoneal dialysis which underwent  bioelectrical impedance measurements with an empty peritoneal cavity, also MIS was applied and biochemical parameters were evaluated. RESULTS: The prevalence of malnutrition with VIBE and MIS was 38% and 24% respectively. Statistically significant differences in body mass index (BMI) and phase angle between normally nourished and wasted patients by both methods were found. Body composition, biochemical parameters and impedance vectors were not statistically different between normally nourished and wasted patients. Concordance between methods was 0.314 (p = 0.019). CONCLUSIONS: Combined nutritional assessment with MIS and BIVA is necessary for the diagnosis of protein energy wasting syndrome in patients undergoing peritoneal dialysis.

Combined assessment of nutritional status in patients with peritoneal dialysis using bioelectrical impedance vectors and malnutrition inflammation score / Evaluación combinada del estado de nutrición en pacientes con diálisis peritoneal mediante vectores de impedancia bioeléctrica y puntaje de inflamación y desnutrición

Background and objective: Protein energy wasting (PEW) is a common syndrome in patients with chronic kidney disease, related to changes in hydration status, decreased food intake and inflammation. There are several tools for the assessment and diagnosis of such alterations. Bioimpedance vector analysis (BIVA) assess the state of nutrition and hydration, but not the inflammatory component, while the malnutrition inflammation score (MIS) comprises the inflammatory and nutritional factors, but not the state of hydration. The aim of the study was to determine the concordance between MIS and BIVA to assess nutritional status in peritoneal dialysis patients. Methods: We studied 50 patients on peritoneal dialysis which underwent bioelectrical impedance measurements with an empty peritoneal cavity, also MIS was applied and biochemical parameters were evaluated. Results: The prevalence of malnutrition with VIBE and MIS was 38% and 24% respectively. Statistically significant differences in body mass index (BMI) and phase angle between normally nourished and wasted patients by both methods were found. Body composition, biochemical parameters and impedance vectors were not statistically different between normally nourished and wasted patients. Concordance between methods was 0.314 (p = 0.019). Conclusions: Combined nutritional assessment with MIS and BIVA is necessary for the diagnosis of protein energy wasting syndrome in patients undergoing peritoneal dialysis (AU)

Antecedentes y objetivo: el desgaste energético proteico (DEP) es un síndrome muy común en pacientes con enfermedad renal crónica, en el que están involucrados alteraciones en el estado de hidratación, descenso de ingestión alimentaria e inflamación. Existen diversas herramientas para la evaluación y detección de dichas alteraciones. Los vectores de impedancia bioeléctrica (VIBE) evalúan el estado de nutrición e hidratación, pero no el componente inflamatorio, mientras que el puntaje de inflamación y desnutrición (MIS) comprende los factores inflamatorio y nutricional, pero no el estado de hidratación. El objetivo del estudio fue determinar la concordancia entre MIS y VIBE para evaluar el estado de nutrición en pacientes en diálisis peritoneal. Material y métodos: se estudió a 50 pacientes en diálisis peritoneal a los cuales se les realizaron mediciones de impedancia bioeléctrica con la cavidad peritoneal vacía, se aplicó el MIS y se evaluaron parámetros bioquímicos. Resultados: la prevalencia de desnutrición por MIS y VIBE fue del 38% y 24% respectivamente. Se encontraron diferencias estadísticamente significativas en índice de masa corporal (IMC) y ángulo de fase entre pacientes normonutridos y desgastados por ambos métodos. Las variables de composición corporal y bioquímicas entre pacientes normonutridos y desgastados por ambos métodos, así como los vectores de impedancia, no fueron estadísticamente diferentes. Se encontró una concordancia entre métodos de 0,314 (p = 0,019). Conclusiones: es necesaria la evaluación nutricia combinada con los métodos MIS y VIBE para un pertinente diagnóstico de desgaste energético proteico en pacientes en diálisis peritoneal (AU)