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Body composition assessment in chronic kidney disease. Jamie Macdonald. Five levels of body composition. Whole body Tissue Cellular Molecular Atomic. Why measure body composition in CKD?.
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Body composition assessment in chronic kidney disease Jamie Macdonald
Five levels of body composition • Whole body • Tissue • Cellular • Molecular • Atomic
Why measure body composition in CKD? • Muscle wasting is linked with morbidity (Ikizler et al., 1999) and mortality (Kato et al., 2003) • Obesity is also associated with outcome (Kalantar-Zadeh et al., 2005)
Effects of body composition on functional capacity Data are Pearson’s r correlation coefficients. *, p < 0.001. Macdonald et al., 2004
Body composition in CKD Macdonald et al., 2004
Whole body level • Something is better than nothing! • Weight • BMI • Interpret results with caution! • Muscle or fat? (Beddhu et al., 2003) • Reverse epidemiology? (Kalantar-Zadeh et al., 2005) • Scales must be calibrated frequently • Remove shoes, wear minimal clothing I don’t believe it!!!
Traditional techniques • Blood biochemistry • Serum pre/albumin • CRP • SGA • Anthropometry • Skin folds • Circumferences • Creatinine kinetics
Bioelectrical impedance Macdonald et al., in submission
Rikli & Jessie Jones, Human Kinetics, 2000 Monitoring progress: functional capacity
Future techniques • Near infra-red spectroscopy (Kalantar-Zadeh et al., 1999) • Bioelectrical impedance • Spectroscopy (Kaysen et al., 2005) • Segmental spectroscopy (Zhu et al., 2006) • Raw electrical data (KDOQI) • Ultrasound(Mercer et al., 2005)