Bioelectrical impedance analysis for measuring body composition in an outpatient haemodialysis setting: A feasibility study

• Published in: Renal Society of Australasia journal Vol. 19; no. 2; pp. 56 - 67
• Main Authors: Gomes, Kristin, Irwin, Chris, Desbrow, Ben, Roberts, Shelley
• Format: Journal Article
• Language: English
• Published: Osborne Park, WA Cambridge Publishing 01.11.2023; Renal Society of Australasia
• Subjects: Attitude surveys; Body composition; Clinical medicine; Clinics; Consent; Data collection; Electronic health records; Evaluation; Feasibility studies; Hemodialysis; Hospitals; Impedance, Bioelectric; Information management; Kidney diseases; Malnutrition; Market surveys; Measurement; Medical records; Medical research; Medicine, Experimental; Muscles; Musculoskeletal system; Nutrition; Patient satisfaction; Physiological aspects; Australia; Ghana; Taiwan
• ISSN: 1832-3804; 2208-4088
• DOI: 10.33235/rsaj.19.2.56-67

Aim: Clinical guidelines recommend using bioelectrical impedance analysis (BIA) to assess body composition in adults with renal failure on maintenance haemodialysis. This study evaluated the feasibility, acceptability and clinical utility of using BIA with haemodialysis outpatients. Methods: Patients attending the haemodialysis outpatient unit at a tertiary public hospital in Australia were consecutively recruited. Participants completed a pre- and post-dialysis BIA measure and satisfaction survey about the measurement process. Primary outcomes pertained to feasibility (recruitment and measurement completion rates). Secondary outcomes included acceptability, assessed via patient satisfaction surveys, and predictive value of BIA for identifying malnutrition according to Subjective Global Assessment (SGA). Continuous variables were presented as mean +/- standard deviation (or median and interquartile range). Binomial logistic regression was performed to determine the predictive value of BIA for identifying malnutrition. Receiver operating characteristic curve analysis was used to evaluate BIA parameters for their ability to discriminate malnourished patients (determined by SGA) from well-nourished patients. Statistical significance was established at p<0.05. Results: A total of 30 of 36 patients approached (83%) consented to participate, with 28 completing at least one BIA measurement and included in data analysis. BIA measurement completion rates were 93% and 87% pre- and postdialysis, respectively. Post-dialysis BIA measures of fat mass index, fat free mass index and skeletal muscle mass most closely reflected SGA-categorised malnutrition. Patients reported high acceptability for BIA, found the process easy, and valued the results. Conclusion: BIA use in an outpatient haemodialysis unit is feasible and acceptable to patients, providing valuable objective data to enhance clinical practice.