Comparison of hydration and nutritional status between young and elderly hemodialysis patients through bioimpedance analysis

Figures & data

Table 1 Baseline characteristics of the patients according to age (demographic and laboratory data)

	Total (n=82)	Age ≥65 years (n=28)	Age <65 years (n=54)	P-value
Age (years)	58.7±12.9	72.5±4.9	51.5±9.4	<0.001
Sex (male), n (%)	42 (51.2)	13 (46.4)	29 (53.7)	0.532
HD duration (months)	48.8±43.4	48.4±51.4	49.0±39.1	0.660
DM, n (%)	47 (57.3)	14 (50.0)	33 (61.1)	0.335
Smokers, n (%)	16 (20.0)	5 (17.8)	9 (20.3)	0.384
Diuretics, n (%)	46 (56.1)	14 (50.0)	32 (59.2)	0.234
ACEi or ARB use, n (%)	39 (47.5)	13 (46.4)	26 (48.1)	0.552
Statin/fibrate use, n (%)	22 (26.8)	7 (25.0)	15 (27.7)	0.320
CVD Hx, n (%)	25 (30.5)	9 (32.1)	16 (29.6)	0.102
SBP (mmHg)	144.4±22.2	144.0±22.1	144.6±22.3	0.744
Hemoglobin (g/dL)	10.3±1.0	10.1±1.0	10.4±1.0	0.667
TIBC (mcg/dL)	213.8±48.1	198.9±35.6	221.4±52.1	0.024
Creatinine (mg/dL)	9.1±3.3	8.1±3.1	9.6±3.2	0.033
Calcium (mg/dL)	8.8±0.6	8.8±0.7	8.9±0.5	0.748
Phosphate (mg/dL)	4.6±1.4	4.2±1.1	4.8±1.5	0.061
Albumin (g/dL)	3.9±0.4	3.8±0.4	3.9±0.3	0.075
CRP (mg/dL)	1.46±0.50	1.55±1.50	1.10±1.06	0.157
Cholesterol (mg/dL)	147.3±33.7	152.5±25.7	144.6±37.1	0.114
Triglyceride (mg/dL)	107.3±74.0	80.5±49.4	121.2±80.9	0.002
HDL-C (mg/dL)	40.5±13.6	45.4±14.9	38.0±12.3	0.030
LDL-C (mg/dL)	80.8±27.3	85.0±27.0	78.5±27.5	0.304
Urine output (mL/day)	405.0±358.9	420.0±431.5	397.5±329.0	0.150
spKt/V	1.21±0.19	1.25±0.17	1.19±0.19	0.304

Note: Variables are expressed as mean ± SD, unless otherwise stated.

Abbreviations: ACEi, angiotensin converting enzyme inhibitor; ARB, angiotensinogen receptor blocker; CRP, C-reactive protein; CVD Hx, cardiovascular disease history; DM, diabetes mellitus; spKt/V, single-pool Kt/V; HD, hemodialysis; HDL-C, high-density lipid-cholesterol; LDL-C, low-density lipid-cholesterol; SBP, systolic blood pressure; TIBC, total iron-binding capacity.

Table 2 Baseline characteristics of the patients according to age (anthropometric data)

	Total (n=82)	Age ≥65 years (n=28)	Age <65 years (n=54)	P-value
BMI (Kg/m^2)	22.9±3.5	23.0±2.6	22.8±4.0	0.778
MAC (cm)	27.1±3.5	26.4±2.3	27.6±3.9	0.091
MAMC (cm)	21.5±4.2	21.0±2.7	21.7±4.8	0.385
TSF (mm)	16.8±6.4	17.2±5.9	16.7±6.7	0.743
HGS (kg)
Male	40.0±23.4	28.2±10.6	44.8±25.6	0.046
Female	23.3±13.6	17.9±7.8	26.6±15.4	0.030
MIS	5.0±2.8	5.5±2.2	4.8±3.0	0.089

Note: All variables are expressed as mean ± SD.

Abbreviations: BMI, body mass index; HGS, hand grip strength; MAC, mid-arm circumference; MAMC, mid-arm muscle circumference; MIS, malnutrition-inflammation score; SD, standard deviation; TSF, triceps skinfold.

Table 3 Comparison of parameters derived from bioimpedance analysis

	Total (n=82)	Age <65 years (n=28)	Age ≥65 years (n=54)	P-value
TBW (L)	32.3±6.7	30.5±6.6	33.3±6.7	0.082
ECW (L)	12.7±2.5	12.3±2.5	13.0±2.5	0.221
ICW (L)	19.6±4.3	18.3±4.0	20.3±4.2	0.043
ECW/TBW	0.39±0.01	0.40±0.01	0.39±0.01	0.001
Protein (kg)	8.4±1.8	7.9±1.7	8.7±1.8	0.043
Mineral (kg)	3.0±0.6	2.8±0.6	3.1±0.5	0.041
Fat mass (kg)	17.1±8.5	18.1±7.3	16.6±9.0	0.405
FFM (kg)	43.8±9.1	41.2±8.9	45.1±8.9	0.069
SLM (kg)	41.3±8.7	38.9±8.4	42.6±8.6	0.072
SMM (kg)	23.5±5.5	21.8±5.3	24.4±5.5	0.043
BCM (kg)	28.0±6.1	26.1±5.8	29.0±6.0	0.044
BMC (kg)	2.5±0.5	2.3±0.5	2.5±0.4	0.043
TBW/FFM	73.8±0.4	74.0±0.4	73.7±0.4	0.004
Phase angle (°)	4.6±1.2	4.0±1.0	4.9±1.2	0.002

Note: All variables are expressed as mean ± SD.

Abbreviations: BCM, body cell mass; BMC, bone mineral contents; ECW, extracellular water; FFM, fat-free mass; ICW, intracellular water; SD, standard deviation; SLM, skeletal lean mass; SMM, skeletal muscle mass; TBW, total body water.

Table 4 Univariable and multivariable linear regression analysis of risk factors associated with hydration (ECW/TBW) and nutritional status (MIS) in total HD patients

	For ECW/TBW				For MIS
	Univariable		Multivariable		Univariable		Multivariable
	β (95%CI)	P-value	β (95%CI)	P-value	β (95%CI)	P-value	β (95%CI)	P-value
Age	0.054 (0.033, 0.075)	<0.001	0.012 (0.001, 0.023)	0.031	0.024 (−0.024, 0.071)	0.327	−0.014 (−0.057, 0.028)	0.502
Sex	−1.051 (−1.630, −0.472)	0.001	−0.100 (−0.493, 0.293)	0.613	−1.929 (−3.078, −0.779)	0.001	−0.574 (−1.616, 0.469)	0.276
DM	1.137 (0.560, 1.714)	<0.001	0.294 (0.021, 0.567)	0.035	0.328 (−1.565, 0.910)	0.600	−0.542 (−1.588, 0.505)	0.305
Alb	−1.531 (−2.311, −0.752)	<0.001	−0.214 (−0.576, 0.149)	0.243	−3.188 (−4.708, −1.669)	<0.001	−0.733 (−2.208, 0.743)	0.325
Uv	−0.002 (−0.007, −0.005)	0.042	−0.001 (−0.006, 0.005)	0.808	−0.060 (−0.082, −0.012)	0.355	−0.655 (−2.388, 0.825)	0.520
HGS	−0.034 (−0.048, −0.020)	<0.001	−0.001 (−0.008, 0.006)	0.799	−0.049 (−0.078, −0.020)	0.001	−0.014 (−0.041, 0.012)	0.280
PhA	−1.067 (−1.164, −0.971)	<0.001	−0.987 (−1.137, −0.837),	<.001	−1.255 (−1.675, −0.835)	<0.001	−0.797 (−1.373, −0.220)	0.008

Notes: All variables are expressed as mean ± SD. Units: age (per 1 year), sex (male), DM (the presence of DM), albumin (per 1 g/dL increase), Uv (per 1 mL increase), HGS (per 1 kilogram-units increase), PhA (per 1° increase).

Abbreviations: ECW, extra cellular water; TBW, total body water; MIS, malnutrition-inflammation score; HD, hemodialysis; DM, diabetes mellitus; Alb, albumin; Uv, urine volume; HGS, handgrip strength; PhA, phase angle.

Figure 1 Pearson’s correlation between age and various parameters in all HD patients.

Abbreviations: BCM, body cell mass; ECW, extracellular water; HD, hemodialysis; HGS, hand grip strength; TBW, total body water.