RESUMO
OBJECTIVES: The prevalence of obesity in the population has increased and excess body adiposity is one of the main nutritional disorders in patients with chronic kidney disease (CKD) on hemodialysis (HD). The objective of this study was to develop equations using anthropometric measurements to predict the total and abdominal body adiposity of patients with CKD on HD. METHODS: This is a cross-sectional study evaluating 323 patients with CKD on HD in city in northeastern Brazil. Measurements and anthropometric indicators were correlated with percentage of body fat (%BF) and visceral fat (VF, in kg) measured by dual energy X-ray absorptiometry. Multiple linear regression models based on different combinations of anthropometric measurements were adjusted to develop the equations, with subsequent cross-validation. RESULTS: Of the 323 patients, 62.2% were male and 46.5% were aged between 40 and 59 years. The equation selected to estimate %BF included weight, height, waist and hip circumferences, and triceps and suprailiac skin folds, presenting high predictive capacity (R2 = 0.771). The equation selected to estimate VF included weight, height, waist circumference, hip circumference, and sum of skin folds (R22 = 0.796). CONCLUSIONS: The proposed equations efficiently predicted the %BF and VF (kg) of patients with CKD on HD, thereby serving as viable indicators in clinical practice.
Assuntos
Absorciometria de Fóton , Adiposidade , Diálise Renal , Insuficiência Renal Crônica , Humanos , Masculino , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Insuficiência Renal Crônica/terapia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/fisiopatologia , Adulto , Brasil , Absorciometria de Fóton/métodos , Antropometria/métodos , Circunferência da Cintura , Gordura Intra-Abdominal/fisiopatologia , Obesidade/complicações , Obesidade/fisiopatologiaRESUMO
INTRODUCTION: Introduction: body fat reflects important clinical impacts among hemodialysis patients; thus, simple and safe methods are required for a careful evaluation of this body compartment. Objectives: to evaluate the concordance of estimates of total body fat percentage (%BF), calculated using bioelectrical impedance analysis (BIA) and sum of four skinfolds (SSKD) measures, with those obtained using dual-energy X-ray absorptiometry (DEXA) in patients with chronic kidney disease (CKD) receiving hemodialysis. Methods: a cross-sectional study was conducted in 317 patients undergoing hemodialysis. The %BF was evaluated using BIA, SSKD measurement, and DEXA, and stratified by sex and tertiles. The Wilcoxon test for paired samples was used to compare the %BF obtained using the different methods, and Lin's concordance correlation coefficient (CCC-L) to evaluate concordance. Results: the average %BF estimated using DEXA was 29.3 ± 9.3 %, with significant differences among the three methods (p < 0.05). SSKD measurement presented a higher CCC-L concordance with DEXA, regardless of sex. After stratification of the sample in tertiles, BIA presented a higher CCC-L concordance with DEXA among the patients with CKD with a %BF above 34.4 % (third tertile). Conversely, SSKD measurement presented better concordance with DEXA for those with a %BF equal to or less than 34.4 %. Conclusions: in terms of the estimates of the %BF, SSKD measurement displayed a better concordance with DEXA.
INTRODUCCIÓN: Introducción: la grasa corporal refleja importantes impactos clínicos entre los pacientes en hemodiálisis; por lo tanto, se requieren métodos simples y seguros para una evaluación cuidadosa de este compartimiento del cuerpo. Objetivos: evaluar la concordancia de las estimaciones del porcentaje de grasa corporal total (%GC), calculadas mediante el análisis de impedancia bioeléctrica (BIA) y la suma de las medidas de cuatro pliegues cutáneos (CPC), con las obtenidas mediante absorciometría dual energética de rayos X (DEXA) en pacientes con enfermedad renal crónica (ERC) que reciben hemodiálisis. Métodos: se realizó un estudio transversal en 317 pacientes en hemodiálisis. La %GC se evaluó mediante BIA, medición de CPC y DEXA, y se estratificó por sexos y terciles. Se utilizó la prueba de Wilcoxon para muestras pareadas para comparar los %GC obtenidos con los diferentes métodos, y el coeficiente de correlación de concordancia de Lin (CCC-L) para evaluar la concordancia. Resultados: el %GC promedio estimado usando DEXA fue del 29,3 ± 9,3 %, con diferencias significativas entre los tres métodos (p < 0,05). La medición de los CPC presentó una mayor concordancia de CCC-L con DEXA, independientemente del sexo. Tras la estratificación de la muestra en terciles, la BIA presentó una mayor concordancia de CCC-L con DEXA entre los pacientes con ERC con un %GC superior al 34,4 % (tercer tercil). Por el contrario, la medición de los CPC presentó una mejor concordancia con la DEXA para aquellos con un %GC igual o inferior al 34,4 %. Conclusión: en términos de las estimaciones del %GC, la medición de los CPC mostró una mejor concordancia con la DEXA.