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Year : 2021  |  Volume : 31  |  Issue : 1  |  Page : 39--42

Body fat in children with chronic kidney disease - A comparative study of bio-impedance analysis with dual energy X-ray absorptiometry

Arpana Iyengar1, Rebecca Kuriyan2, Anura V Kurpad2, Anil Vasudevan1 
1 Department of Pediatric Nephrology, St John's Medical College Hospital, Bengaluru, Karnataka, India
2 Division of Nutrition, St John's Research Institute, St John's National Academy of Health Sciences, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Arpana Iyengar
Department of Pediatric Nephrology, St John's National Academy of Health Sciences, Bengaluru - 560 034, Karnataka
India

Introduction: Nutritional impairment in patients with chronic kidney disease (CKD) is due to decreased body stores of both protein and fat. We need a tool that can be used in clinics to determine and monitor fat composition with a special focus on normalizing fat measurements to height in these children. Bio-impedance analysis (BIA), a portable and simple tool, has been used to estimate body fat in children with CKD but needs validation against the reference tool dual energy X-ray absorptiometry (DXA). The purpose of the cross-sectional study was to estimate the prevalence of low body fat in children with stages 2-5 CKD (non-dialysis) and CKD 5D (dialysis), and to compare fat measures from two different methods namely BIA and DXA. Method: Children in stages 2–5 CKD (n = 19) and in CKD 5D (n = 14) were recruited for assessment of fat mass (FM, Kg) by BIA and DXA, from which percent body fat (BF %) and fat mass index (FMI, Kg/M2) were obtained. Low body fat was defined as <5th age and gender centile for BF% or FMI by DXA and BF% by BIA. Results: Low body fat was detected equally using BF% and FMI in 18% of children by DXA while only 12% were detected using BF% by BIA. In children with CKD2–5, a good degree of reliability was found with FMI measurements (ICC 0.76 CI [0.48,0.9]) and poor reliability in children with CKD 5D (ICC 0.58 CI [0.1,0.84]). BF% had poor to fair reliability in the children with CKD 2-5 and CKD 5D (ICC 0.64 [0.28,0.84] and 0.53 [0.02,0.82]), respectively. Comparing BF% and FMI obtained by BIA and DEXA, BIA overestimated BF% by 3.5% in comparison to DXA. Conclusion: In children with CKD, body fat is preserved in the majority. Among the two measures of fat, BF% estimated by BIA did not compare well with DXA while FMI measure was comparable with a lower bias. However, due to lack of reference values in Indian children for FMI obtained by BIA, BIA cannot be used to measure fat in this population.

How to cite this article:
Iyengar A, Kuriyan R, Kurpad AV, Vasudevan A. Body fat in children with chronic kidney disease - A comparative study of bio-impedance analysis with dual energy X-ray absorptiometry.Indian J Nephrol 2021;31:39-42

How to cite this URL:
Iyengar A, Kuriyan R, Kurpad AV, Vasudevan A. Body fat in children with chronic kidney disease - A comparative study of bio-impedance analysis with dual energy X-ray absorptiometry. Indian J Nephrol [serial online] 2021 [cited 2021 Apr 11 ];31:39-42
Available from: https://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2021;volume=31;issue=1;spage=39;epage=42;aulast=Iyengar;type=0