Reliability of Bioelectrical Impedance Analysis in the Evaluation of the Nutritional Status of Hemodialysis Patients d A Comparison With Mini Nutritional Assessment an, E. Tutal, M.E. Uyar, Z. Bal, B.G. Demirci, B. Sayın, and S. Sezer E. Erdog ABSTRACT Introduction. Protein-energy wasting (PEW) is a strong predictive factor for morbidity and mortality in patients who have end-stage renal disease (ESRD). Mini Nutritional Assessment (MNA) is an important and confirmed tool to evaluate PEW that has been recommended by many guidelines. Bioelectrical impedance analysis (BIA) is a noninvasive technique for assessing body composition. The aim of the present study was to analyze the reliability of BIA in malnutrition diagnosis by comparing it with standard MNA in a group of 100 ESRD patients. Methods. One hundred ESRD patients who were medically stable and under dialysis treatment for at least 6 months were enrolled to the study. Monthly assessed serum creatinine, albumin, C-reactive protein (CRP), and lipid profiles from the last 6 months prior to the study were retrospectively collected. A standard Full-MNA and body composition analyses were applied to all patients. Body compositions were analyzed with the BIA technique using the Body Composition Analyzer (Tanita BC-420MA; Tanita, Tokyo, Japan). Patients were classified into three groups according to MNA scores as PEW (n ¼ 15, score 1.2. Predialysis and immediate postdialysis blood urea nitrogen levels were used to calculate the monthly Kt/V values by means of a single-compartment model of hemodialysis urea kinetics. Monthly assessed biochemical parameters including serum creatinine, albumin, C-reactive protein (CRP), total cholesterol, low-density lipoprotein (LDL) cholesterol and triglyceride levels from the last 6 months were retrospectively collected and measured using standard laboratory techniques. The mean value of each parameter was recorded as final data. A standard MNA and body composition analysis were applied to all patients. Body compositions were measured using the Tanita BC-420MA Body Composition Analyzer (Tanita, Tokyo, Japan). For the BIA measurements, the subject stood in an upright position with bare feet on the analyzer footpads. The impedance between the two feet was measured while
an alternating current (50 kHz and w200 mA) passed through the lower body. Patients were classified into three groups according to MNA scores as PEW (n ¼ 15, score
an alternating current (50 kHz and w200 mA) passed through the lower body. Patients were classified into three groups according to MNA scores as PEW (n ¼ 15, score
