PMID- 31060893
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20210818
IS  - 1532-1983 (Electronic)
IS  - 0261-5614 (Linking)
VI  - 39
IP  - 4
DP  - 2020 Apr
TI  - Extracellular mass to body cell mass ratio as a potential index of wasting and 
      fluid overload in hemodialysis patients. A case-control study.
PG  - 1117-1123
LID - S0261-5614(19)30197-9 [pii]
LID - 10.1016/j.clnu.2019.04.021 [doi]
AB  - BACKGROUND & AIMS: Extracellular mass-to-body cell mass ratio (ECM/BCM ratio) 
      which differentiates the proportion between intraextracellular compartments, 
      could be a nutrition index of being wasted overloaded in hemodialysis (HD) 
      patients. This study aimed to describe a cut-off point of the ECM/BCM ratio and, 
      to find out the relationship between the nutritional-hydration status and this 
      ratio in HD patients. METHODS: A case-control study was carried out in 64 HD 
      patients individually age-gender-matched to controls. Demographic, clinical and 
      laboratory parameters were recorded. Bioelectrical impedance analysis was used to 
      estimate ECM/BCM ratio as an indicator of the nutritional hydration status. 
      Receiver operator characteristic (ROC) curve analysis was applied to determine 
      the optimal cut-off point for identification of ECM/BCM ratio. An univariate and 
      multivariate conditional logistic regression for the ECM/BCM ratio >/=1.20 was 
      performed. RESULTS: Median of ECM/BCM ratio was 1.50 (IQR:0.66) in HD patients, 
      whereas 0.87 (IQR: 0.35) was found in controls (p < 0.001). HD-patients had lower 
      body weight, serum albumin (s-albumin) and higher serum C-reactive protein 
      (s-CRP) than controls. By ROC curve analysis, a cut-off point of 1.20 for the 
      ECM/BCM ratio best discriminates to be wasted-overhydrated (sensitivity: 81.2%; 
      specificity: 87.5%). Conditional logistic regression showed that for each 10%, 
      ECM/BCM ratio increase the probability of developing fluid overload was increased 
      63% (OR: 1.63; 95% CI, 1.15-2.29), whereas an inverse association with s-albumin 
      (OR: 0.15; 95% CI, 0.03-0.61) and other nutritional indicators were found. 
      CONCLUSIONS: The ECM/BCM ratio appears as a sensitive index that discriminates 
      nutritional and/or hydration status in HD patients compared with 
      age-gender-matched-controls. ECM/BCM ratios >/=1.20 are indicators of wasting and 
      fluid overload in HD patients.
CI  - Copyright (c) 2019 Elsevier Ltd and European Society for Clinical Nutrition and 
      Metabolism. All rights reserved.
FAU - Ruperto, Mar
AU  - Ruperto M
AD  - Human Nutrition Department, Faculty of Health Sciences, University Alfonso X el 
      Sabio, 28697, Villanueva de la Canada, Madrid, Spain. Electronic address: 
      marruperto@yahoo.com.
FAU - Sanchez-Muniz, Francisco J
AU  - Sanchez-Muniz FJ
AD  - Nutrition and Bromatology Department (Nutrition), Faculty of Pharmacy, 
      Universidad Complutense de Madrid, Spain.
FAU - Barril, Guillermina
AU  - Barril G
AD  - Nephrology Department, Hospital Universitario La Princesa, Madrid, Spain.
LA  - eng
PT  - Journal Article
DEP - 20190424
PL  - England
TA  - Clin Nutr
JT  - Clinical nutrition (Edinburgh, Scotland)
JID - 8309603
SB  - IM
CIN - Clin Nutr. 2020 Jan;39(1):326. PMID: 31668427
CIN - Clin Nutr. 2020 Jan;39(1):316-317. PMID: 31812469
CIN - Clin Nutr. 2020 May;39(5):1628-1629. PMID: 32249113
MH  - Aged
MH  - Body Composition/*physiology
MH  - *Body Mass Index
MH  - Cachexia/*diagnosis/physiopathology
MH  - Case-Control Studies
MH  - Electric Impedance
MH  - Female
MH  - Humans
MH  - Male
MH  - Nutritional Status/*physiology
MH  - Renal Dialysis/*adverse effects
MH  - Spain
MH  - Water-Electrolyte Imbalance/*diagnosis/physiopathology
OTO - NOTNLM
OT  - Bioelectric impedance analysis
OT  - Extracellular mass-to-body cell mass ratio
OT  - Fluid overload
OT  - Hemodialysis
OT  - Protein-energy wasting
EDAT- 2019/05/08 06:00
MHDA- 2021/08/19 06:00
CRDT- 2019/05/08 06:00
PHST- 2018/12/03 00:00 [received]
PHST- 2019/04/02 00:00 [revised]
PHST- 2019/04/16 00:00 [accepted]
PHST- 2019/05/08 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2019/05/08 06:00 [entrez]
AID - S0261-5614(19)30197-9 [pii]
AID - 10.1016/j.clnu.2019.04.021 [doi]
PST - ppublish
SO  - Clin Nutr. 2020 Apr;39(4):1117-1123. doi: 10.1016/j.clnu.2019.04.021. Epub 2019 
      Apr 24.