Alibrandi Maria Teresa Sciarrone, Pisoni Matteo Brambilla, Rivera Rodolfo Fernando, Catania Martina, Vespa Marta, De Rosa Liliana Italia, Bucci Romina, Kola Kristiana, Farinone Sara, Citterio Lorena, Vergani Maria Vittoria, Manunta Paolo, Vezzoli Giuseppe
Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vita Salute San Raffaele University, Milan, Italy.
J Nephrol. 2025 Jul 22. doi: 10.1007/s40620-025-02327-0.
Bioelectrical impedance analysis is a non-invasive method used to assess body composition and nutritional status in patients with chronic kidney disease (CKD). However, its reliability in autosomal dominant polycystic kidney disease (ADPKD) remains uncertain due to altered fluid distribution caused by cystic organ enlargement. This cross-sectional study compared bioelectrical impedance analysis-derived body composition and nutritional parameters between patients with ADPKD and those with non-ADPKD CKD.
A total of 218 CKD patients (71 with ADPKD and 147 with non-ADPKD CKD, stages 1-5D) were enrolled. To control for baseline differences, 1:1 propensity score matching was applied. All participants underwent bioelectrical impedance analysis to assess body water compartments, skeletal muscle mass, fat mass, and phase angle. In the ADPKD group, parameters were further analyzed based on the presence of organomegaly, defined as nephromegaly (total kidney volume > 750 mL or kidney length > 16 cm) or hepatomegaly (liver transverse diameter > 25 cm).
After matching, two balanced groups of 71 patients each were compared. ADPKD patients showed significantly higher total and extracellular water than controls, both as absolute values normalized to height squared and as a percentage of body weight. Among ADPKD patients, the 41 with organomegaly had significantly lower phase angle, fat mass, fat-free mass, and skeletal muscle mass than the 30 without organomegaly-despite a paradoxical increase in body mass index (BMI). These changes were independent of kidney function.
Bioelectrical impedance analysis detected altered fluid distribution and early signs of malnutrition and sarcopenia in ADPKD, supporting the need for proactive nutritional monitoring, especially in patients with organomegaly.
生物电阻抗分析是一种用于评估慢性肾脏病（CKD）患者身体成分和营养状况的非侵入性方法。然而，由于囊性器官肿大导致液体分布改变，其在常染色体显性多囊肾病（ADPKD）中的可靠性仍不确定。这项横断面研究比较了ADPKD患者和非ADPKD的CKD患者之间生物电阻抗分析得出的身体成分和营养参数。
共纳入218例CKD患者（71例ADPKD患者和147例非ADPKD的CKD患者，1-5D期）。为控制基线差异，采用1:1倾向评分匹配。所有参与者均接受生物电阻抗分析，以评估身体水分 compartments、骨骼肌质量、脂肪质量和相位角。在ADPKD组中，根据器官肿大情况进一步分析参数，器官肿大定义为肾肿大（总肾体积>750 mL或肾长>16 cm）或肝肿大（肝横径>25 cm）。
匹配后，比较了两组各71例平衡的患者。ADPKD患者的总水量和细胞外水量均显著高于对照组，无论是相对于身高平方的绝对值还是占体重的百分比。在ADPKD患者中，41例有器官肿大的患者的相位角、脂肪质量、去脂体重和骨骼肌质量显著低于30例无器官肿大的患者，尽管体重指数（BMI）出现了矛盾的增加。这些变化与肾功能无关。
生物电阻抗分析检测到ADPKD患者的液体分布改变以及营养不良和肌肉减少症的早期迹象，支持进行积极的营养监测，尤其是对有器官肿大的患者。
