지속성 외래 복막투석 환자의 제지방무게 측정법의 비교

Abstract

Malnutrition is cormnon in continuous ambulatory peritoneal dialysis(CAPD) patients, Previous studies showed that 18-56% of CAPD patients were suf- fering from varying degrees of malnutrition. Malnu- trition reflects inadequate dialysis or improper die- tary intake, leading to a reduction in lean body mass(LBM). Monitoring of LBM, therefore is impor- tant for long-term nutritional assessment of CAPD patients. At present, dual energy X-ray absorptio- metry(DEXA) is known to accurately predict body compositions in normal and dialysis patients. To determine the most convenient and cost effective tool for LBM measurement, the present cross- sectional study was carried out assessing LBM by DEXA as well as by four other techniques' anthro- pometry, bioelectrical impedance analysis, infrared interactance and creatinine kinetics. 1) Subjects were 15 rnen and women each, all clinically stable with a mean CAPD duration of 35.5 months. The mean concentration of serum albumin was 3.9±0.5g/dl, normalized protein catabolic rate (NPCR) 0.98±0.16g/kg/day, KT/Vurea 2.08±0.34 and standardized creatinine clearance(SCCr) 65.8±22.1 Vweek/1.73m2. 2) Significant correlations between LBM measured by DEXA and LBM measured by other methods were found(r>0.833, p<0.05). Compared with DEXA, the best result was found with anthropometry as it had the highest r value in both measurements of LBM and %LRM(r values are 0.899 and 0.908, respectively). 3) The mean prediction error and root mean sq- uared prediction error was lowest between LBM by anthropometry and that by DEXA. 4) LBM showed no correlation with serum albumin, NPCR, KT/Vurea, and SCCr. In conclusion, anthropometry accurately predicts LBM and may be a suitable alternative tool compared to DEXA in stable CAPD patients.