NEPHROLOGY
Assist in establishing effective dialysis treatment options
Disclaimer: InBody devices should be used as an adjunct tool for clinical decision-making and are not intended to diagnose or treat any diseases
Why is body composition analysis an effective tool for dialysis programs?
InBody devices take the guesswork out of dialysis treatments to help identify the most effective treatment options for the patient and obtain individualized ideal goal weights. In 90 seconds, professionals can use the InBody to:
- Obtain objective fluid measures to guide goal weight management
- Assess muscle and fat mass to make nutritional changes
- Evaluate segmental fluid imbalances to identify circulation issues
- Recognize fluid accumulation and its impact on cellular health
ECW RATIO ANALYSIS
Increase success of dialysis treatment and long-term outcomes
Indirect measures of fluid retention to determine fluid removal and when to discontinue dialysis may lead to intradialytic complications, such as hypo- or hypertension. The study by Son et al., 2022 relates measurements of ECW/TBW with these types of complications. As such, direct fluid measures may improve precision (Choi et al., 2022) and help establish goal weights, possibly reducing health risks. As shown by Kim et al., 2022, high volume status may be associated with decreases in muscle mass and performance. Chida et al., 2022 explain the importance of improving nutritional parameters and patient-reported outcomes in older dialysis patients. Highlighting that the amounts of fat and muscle mass did not change with dry weights.
SEGMENTAL ECW RATIO ANALYSIS
Prevent complications from fluid accumulation during dialysis
Segmental ECW/TBW Analysis can differentiate fluid accumulation from muscle and fat composition, enabling more accurate tracking of fluid overload independent of nutritional status. Barril et al., 2021 discuss the importance of monitoring ECW/TBW as a parameter for assessing hydration status and setting goal weights. With this information, physicians could set proper, long-term goal weights with adjustments as needed, and confirm fluid volumes post-dialysis. Further, Seto et al., 2022 assessed long-term body composition changes in hemodialysis patients, and suggested that inflammation control, along with nutrition, can help minimize muscle mass loss.
MUSCLE-FAT ANALYSIS
Balance individual muscle and fat development
Long-term dialysis can impact lifestyle habits like diet and exercise, resulting in malnutrition and muscle loss (Seto et al., 2022). Recognizing changes in body composition may help tailor nutrition plans and educate patients on the importance of maintaining muscle and fat balance.
When normal food intake and exercise are limited, due to restrictions during intradialytic periods, it can cause malnutrition and alter body composition, making it challenging to determine the appropriate dry weights. A study by Furuya et al., 2022 investigates the association of nutritional risk, motor function, and skeletal muscle mass index (SMI) in elderly hemodialysis patients. The InBody test tracks changes in body composition, as seen in this study by Kittiskulnam et al., 2021 in which the reduction of muscle was associated with glomerular filtration rate (GFR) decline. Additionally, Son et al., 2022 found that hypotension may be prevented with improved skeletal muscle mass maintenance in older hemodialysis patients.
WHOLE BODY PHASE ANGLE
Gain insights into the effects of fluid accumulation on cellular health
When excess fluid builds up around our cells, it can cause pressure that affects their form, structure, function, and stability. InBody can objectively track edema progression and treatment effects using Phase Angle (PhA), which reflects cell membrane integrity and nutritional status. Zhou et al., 2021 explored how PhA and body composition can predict protein-energy wasting (PEW) in patients undergoing renal replacement therapy (RRT), finding PhA a reliable, noninvasive predictor of PEW and nutritional status in elderly RRT patients. Additionally, Kang et al., 2022 found that PhA is linked to muscle mass, strength, and physical functions in maintenance hemodialysis patients, providing physicians with the ability to provide interventions that prevent, or treat, sarcopenia.
Actual Case
Tall: 165cm
Age : 52 years old
Location: A hospital in Gyeonggi-Do
Weight : 63.0kg
Gender : Male
Special note: Still overhydrated after dialysis, and InBody suggested lowering the dry weight by 0.7kg (ECW ratio at 0.395).
Doctor’s reference: Based on the X-ray, the patient is overhydrated but it is difficult to remove more water as the patient’s condition is not good. Need to be careful as continuous overhydration can cause hypertension, edema, and an enlarged heart.
Tall: 165cm
Age : 52 years old
Location: A hospital in Gyeonggi-Do
Weight : 63.0kg
Gender : Male
Special note: Still overhydrated after dialysis, and InBody suggested lowering the dry weight by 0.7kg (ECW ratio at 0.395).
Doctor’s reference: Based on the X-ray, the patient is overhydrated but it is difficult to remove more water as the patient’s condition is not good. Need to be careful as continuous overhydration can cause hypertension, edema, and an enlarged heart.
