Cambios en los parámetros de composición corporal en pacientes en hemodiálisis y diálisis peritoneal

introduction: proper hydration is one of the major aims in haemodialysis (hd) and peritoneal dialysis (pd). bioimpedance spectroscopy appears to be a promising method for the evaluation and follow up of the hydration status in dialysis patients (p). objectives: we compared body composition between stable patients on hd and pd after six months. patients and method: an observational study with 62 p on hd and 19 p on pd was performed. clinical, biochemical and bioimpedance parameters were analysed. results: in the comparative study, pd p were younger (50±10 vs 57±14 years, p=.031). the charlson comorbidity index (4.8±3 vs 7.5±3, p<.001), time on dialysis (16.9±18.01 vs 51.88±68.79 months, p=.020) and c-reactive protein [3 (3-9.3) vs 5.25 (1-76.4)] were lower. total protein levels (7.46±0.44 vs 7.04±0.55 g/dl, p=.005) and transferrin levels (205±41 vs 185±29 mg/dl, p=.024) were higher. bis: intracellular water (19.67±3.61 vs 16.51±3.36 litres, p=.010), lean tissue mass (ltm) (37.20±8.65 vs 32.57±8.72 kg, p=.029), total cellular mass (tcm) (20.53±5.65 vs 17.56±5.91 kg, p=.033), and bioelectrical impedance phase angle (phi 50) (5.81±0.86 vs 4.74±0.98, p=.000) were higher than in hd p. overhydration: 22% in hd y 10% in pd, in conditions referred to in methods. six months later, pd p increased in weight (73.75±12.27 vs 75.22±11.87 kg, p=.027), total fat (fat) (26.88±10 vs 30.02±10 kg, p=.011) and relative fat (rel fat) (35.75±9.87 vs 39.34±9.12, p=.010); and decreased in icw (18.56±3.45 vs 17.65±3.69 l, p=.009), ltm (36.95±8.88 vs 34±9.70 kg, p=.008) and relative ltm (rel ltm) (50.85±12.33 vs 45.40±11.95%, p=.012). in the multivariate analysis, weight variation (δ) was related to δ fat (p<.001). we found a correlation between fat increase and lean tissue mass decrease. six months later, in hd p, we observed a reduction in ecw (15.11±2.45 vs 14.00±2.45, p.001), without changes in other parameters. conclusions: bioelectrical impedance analysis facilitates the assessment of ch