G.Barril, S. Cigarran, M. Farré, A.Mancha*, I. Ulibarri*, R. Selgas

Servicio de Nefrología (Unidad Prediálisis) y Nutrición*.Hospital U.de la Princesa Madrid. ESPAÑA

Nutritional status is evaluated in 56 patients inclouded in our multidisciplinary Predialysis Unit, with x age 70,84±11,74 yr (28-90), 29(51,8%) were males.

The parameters analized were: Demographic and biochemistries: age, gender,BMI, Albumin , PCR, Hb, CrCl/1¨73m2, GFR, MDRD, nPNA, and comorbidity index..The outcome was:
x BMI 25,92±4,26(16,9-37,5), x ICDE (comorbidity index) 2±1,13(r 0-3).
X Albumin 3,85±0,34 (r 2,6-4,40) x MDRD 15,55±5,08 (r 6,5-31,9)
X PCR 0,79±1,44(r 0,10-6,81) x CrCl/1´73m2 18,9±6,9 (r 6,1-35,9)
X Hb 11,4±1,60 (r 4,40-14,8) x nPNA 0,98±0,26 (r 0,40-1,58)

All patients were studied with Bioimpedance monofrequency BIA being the results in a basal cross sectional. as follow:
x % lean body mass71,65±18,38 p 0,000 x % theoric lean body mass78,45±2,64
x % fat body mass 25,89±15,18 p 0,000 x % theoric fat body mass 21,51±2,66
x % water 54,42±8,88 p 0,000 x % theoric water 49,62±3,29
x basal metabolism 1578´3±248,99, x BIA 482,03±96,86.
x braquial circunference 27,7±3,09(r 25-35).

Anthropometric measures: We evaluated

  • biccipital fold (BF) 8,5±5,1,
  • Triccipital (TF) 15,6±6,8,
  • subescapularis (SEF) 16±5,7,
  • y Suprailiac (SIF) 12,5±5,52,
  • also perimeters of waist and hip.

We found significant differences between % of slice mass ( than theoric) and water (>than theoric) in the patients with BIA, as malnutrition marker. Appear sig. differences according to gender in % slice mass (p 0,027), % fat mass p(0,001), % of water (0,000), basal metabolism (p0,000), braquial circunference (p0,027), BMI (p0,026), not in nPNA (p0,081), age, ICDE, Hb, albumin, CrClbs, MDRD nor PCR.

We find also sig. correlation between BIA and nPNA p 0,034, weekly Kt/v p 0,039, braquial circunference (p0,01), basal metabolism. p0,0001,and fold SE, SI and Hb. Serum albumin level is sig. correlated to MDRD 0,03 and braquial circunference 0,017;; nPNA with : Kt/v s(p 0,000), CrClbs (p0,000), Hb and braquial circunference 0,034, so as with folds: TF, SEF and SIF .

We repeated BIA after to modified protein intake to obtein a nPNA >1g/Kgr/day and observed an improuvement in a corporal distribution


    1) In predialysis patients the assesment nutritional status is mandatary to prevent desnutrition and descrease morbimortality.

    2) From the antropometric dates the braquial circunference is the most reproductible anthropometric measure and is correlationated with albumin.

    3) Albumin level is a very important index but to later stage.

    4) BIA established useful tool to evaluate nutritional status in predialysis patients, joint another parameters as nPNA and Hb.