Roth-Stefanski Cristina Techy, Rodrigues de Almeida Naiane, Biagini Gilson, Scatone Natália K, Nerbass Fabiana B, de Moraes Thyago Proença
Pontificia Univerdidade Catolica do Parana, Post Graduate Program in Health and Biological Sciences, Curitiba, Brazil.
Santa Casa de Misericórdia de Curitiba, Curitiba, Brazil.
Front Med (Lausanne). 2021 Aug 25;8:702749. doi: 10.3389/fmed.2021.702749. eCollection 2021.
To analyze the concordance and agreement between bioimpedance spectroscopy (BIS) and anthropometry for the diagnosis of protein energy wasting (PEW) in chronic peritoneal dialysis patients. Prospective, multi-center, observational study using multifrequency bioimpedance device ( ) and anthropometry for the diagnosis of PEW as recommended by the International Society of Renal Nutrition and Metabolism (ISRNM). Cohen's kappa was the main test used to analyze concordance and a Bland-Altmann curve was built to evaluate the agreement between both methods. We included 137 patients from three PD clinics. The mean age of the study population was 57.7 ± 14.9, 47.8% had diabetes, and 52.2% were male. We calculated the scores for PEW diagnosis at 3 and 6 months after the first collection (T3 and T6) and on average 40% of the study population were diagnosed with PEW. The concordance in the diagnosis of PEW was only moderate between anthropometry and BIS at both T3 and T6. The main factor responsible for our results was a low to moderate correlation for muscle mass in kilograms, with an r-squared (R2) of 0.35. The agreement was poor, with a difference of more than 10 kg of muscle mass on average and with more than a quarter of all cases beyond the limits of agreements. Current diagnosis of PEW may differ depending on the tools used to measure muscle mass in peritoneal dialysis patients.
分析生物电阻抗光谱法（BIS）与人体测量法在诊断慢性腹膜透析患者蛋白质能量消耗（PEW）方面的一致性和相关性。采用前瞻性、多中心观察性研究，使用多频生物电阻抗设备（ ）和人体测量法，按照国际肾脏营养与代谢学会（ISRNM）的建议诊断PEW。Cohen's kappa系数是用于分析一致性的主要检验方法，并构建Bland-Altmann曲线来评估两种方法之间的相关性。我们纳入了来自三个腹膜透析诊所的137名患者。研究人群的平均年龄为57.7±14.9岁，47.8%患有糖尿病，52.2%为男性。我们计算了首次采集后3个月和6个月（T3和T6）时PEW诊断的得分，平均有40%的研究人群被诊断为PEW。在T3和T6时，人体测量法与BIS在PEW诊断方面的一致性仅为中等。导致我们研究结果的主要因素是千克肌肉量的相关性低至中等，决定系数（R2）为0.35。两者的相关性较差，平均肌肉量差异超过10千克，超过四分之一的病例超出了一致性界限。目前，腹膜透析患者PEW的诊断可能因用于测量肌肉量的工具不同而有所差异。
