Bioelectrical impedance analysis as a marker of nutritional status in chronically ill patients

Abstract

Objective: The aim of the study was to evaluate different methods of nutritional status analysis like basic anthropometric data, laboratory data and bioelectrical impedance analysis (BIA) with phase angle (PA) in patients with chronic diseases.

Setting: Clinic for Internal Medicine, Department of Nephrology, University Clinical Centre Maribor, a tertiary referral centre in Slovenia, Europe.

Subjects: Patients with chronic disease and increased nutritional risk (≥1 fulfilled NRS 2002 criterion) at the time of inclusion in the study.

Results: Patients had chronic kidney disease (93%), arterial hypertension (80%), active infection (33.3%), heart failure (23.3%), diabetes mellitus (20%), active malignancy (10%), autoimmune disease (6.6%), history of stroke (6.6%), chronic obstructive pulmonary disease (3.3%) and/or liver cirrhosis (3.3%). Mean serum albumin was 33.6±5.7 g/L, mean BMI 25.6±4.4 kg/m2 and mean PA 4.4±1.2º. No correlation between serum albumin and BMI was found. Lower PA was associated with lower serum albumin (p=0.045) and advanced age (p=0.043). The department nurses conducted nutritional education for all patients included in the study. Study was performed in accordance with the Strengthening the reporting of observational studies in epidemiology.

Conclusion: Results of the study show the importance of nutritional risk assessment in all chronically ill patients. BIA is a promising method of determining nutritional status. PA values have important diagnostic, therapeutic and prognostic implications as they are a marker of body cell mass, membrane function and metabolic health. A multifaceted approach to assess malnutrition in patients with chronic diseases is important, followed by a prompt nutritional intervention.