Composición corporal en pacientes en hemodiálisis: relación con la modalidad de hemodiálisis, parámetros inflamatorios y nutricionales

introduction: overweight and obesity are associated to a higher cardiovascular risk and mortality in the general population and conflicting findings exist in the dialysis population. adipokines (leptin, adiponectin) produced in adipocytes may play a role in that process, and inflammatory parameters (crp, il-6) may be markers for it. nevertheless, obtaining dry weight is today one of the main aims of adequacy in dialysis because overhydration is a clear mortality predictor. objectives: the aim of this study was to analyse body composition using an impedance spectroscopy technique in patients on haemodialysis (hd): and evaluate overweight and overhydration prevalence and its possible relation with adipokines, inflammatory and nutritional parameters, hd technique (conventional [chd], on-line haemodiafiltration [ol-hfd]) and erythropoietin needs. methods: in a cross-sectional observational study, a pre-hd multifrequency bioimpedance spectroscopy (bis) was performed in the middle of the week on 77 hd outpatients: 56 chd and 21 ol-hfd. patients were considered overweight when body mass index (bmi) was ≥25kg/m2 and overhydrated when overhydration normalised for extracellular water was higher than 0.15l. clinical and biochemical parameters were analysed and il-6, leptin and adiponectin levels were determined. this information was analysed in overweight and non-overweight, regular and overhydrated patients and both hd techniques. results: 50% of patients fulfilled overweight criteria and 21% were pre-hd overhydrated. overweight patients had a superior fat and extracellular water content (p<.001). leptin (p=.001) and crp (p=.036) levels were higher and adiponectin levels were lower (p=.003). an inverse correlation did exist between bmi and lean mass (p=.01). nutritional markers (prealbumin, albumin, total proteins, creatinine and transferrin) were related to lean mass (p=.05). comparing both hd techniques, a lower fat content was observed in ol-hfd (p=.049) without overhydrat