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Estimation of total-body and limb muscle mass in hemodialysis patients by using multifrequency bioimpedance spectroscopy^1,2,3

¹ From the Renal Research Institute, New York, NY (GAK, FZ, SS, CK, MKK, and NWL); the Division of Nephrology, Department of Medicine, University of California, Davis, Davis, CA (GAK); the Research Service, VA Northern California Health Care System, Mather, CA (GAK); and St Lukes Hospital, New York, NY (SBH and JW)

Background: Skeletal muscle mass can be measured noninvasively with magnetic resonance imaging (MRI), but this is time-consuming and expensive.

Objective: We evaluated the use of multifrequency bioimpedance spectroscopy (BIS) measurements of intracellular volume (ICV) to model total-body skeletal muscle mass (TBMM) and limb skeletal muscle mass in hemodialysis patients.

Design: TBMM was measured by MRI in 20 male and 18 female hemodialysis patients with a median (range) age of 54 y (33–73 y), weight of 78.9 kg (43.2–120 kg), and body mass index (BMI; in kg/m²) of 27.3 (19.4–46.6). We measured total body water (TBW) by using D₂O dilution, extracellular volume (ECV) as bromide space, and ICV as TBW minus bromide space. Total body potassium (TBK) measured as ⁴⁰K was used as an independent model of TBMM. BIS was used to measure whole-body TBW (ankle to wrist) and TBW in the arms and legs. BIS-estimated ICV was used to construct models to calculate limb muscle mass and TBMM. The latter was compared with models derived from isotopic methods.

Results: BIS yielded a model for TBMM [TBMM = 9.52 + 0.331 x ICV + 2.77 (male) + 0.180 x weight (kg) – 0.133 x age] (R² = 0.937, P < 0.0001) as precise as TBK-measured TBMM [TBMM = 1.29 + 0.00453 x TBK (mEq) + 1.46 (male) + 0.144 x weight (kg) – 0.0565 x age] (R² = 0.930, P < 0.0001) or isotopic methods. BIS models were also developed for measuring leg and arm muscle mass.

Conclusion: BIS provides an estimate of TBMM that correlates well with isotopic methods in approximating values obtained by MRI and can be used to estimate limb muscle mass.

Key Words: Body composition • body cell mass • nutrition • extracellular fluid • total body water • bioimpedance spectroscopy • hemodialysis patients

This article has been cited by other articles:

				P. Kotanko, N. W. Levin, and F. Zhu Current state of bioimpedance technologies in dialysis Nephrol. Dial. Transplant., March 1, 2008; 23(3): 808 - 812. [Full Text] [PDF]