Korean Journal of Nephrology 1999;18(2):258-264.

만성 신부전 환자의 영양평가 지표로서의 DEXA의 유용성 (The Usefulness of DEXA about Nutritional Assesment in Chronic Renal Failure)

송상헌, 박성민, 성은영, 이수봉, 이우철, 정현철, 곽임수, 나하연 (Sang Heun Song, Sung Min Park, Soo Bong Lee, Eun Young Sung, Hyun Chul Jung, Woo Chul Lee, Ihm Soo Kwak and Ha Yeon Rha)

Abstract

It has been considered that the nutrition affects the mortality of chronic renal failure patients. Thus, several studies reported the method of examination about nutritional status in chronic renal failure patients. The purpose of the present study was to evaluate the nutritional status of 32 chronic renal failure patients, and recommend DEXA as a objective method. Thirty two chronic renal failure patients and 24 disease-free persons on kidney(control group) were included in this syudy. There were no difference in mean age, sex, weight, height, body mass index between two groups. We measured % total body fat, fat-free mass, limb fat, trunl fat, limb fat/trunk fat ratio with Hologic QDR 4500. The results were as follows. 1)% Total body fat of chronic renal failure patients was 20.7±7.9%. That was lower than 26.3±7.9% of control group(P<0.05). 2)Fat-free mass of chronic renal failure patients revealed lower result compared with control group. Each result was 40.2±12.2kg, 46.2±9.1kg(P<0.05). 3)Despite of no significant difference between two groups in ratio of limb fat and trunk fat, limb fat and trunk fat were statistically different(Limb fat:CRF-5.6±2.4kg, Control-7.1±1.9kg, Trunk fat:CRF- 5.2±3.0kg, Control-7.7±2.7kg)(P<0.05). 4)Triceps skinfold thockness was positively correlated with % total body fat, limb fat, trunk fat, and negatively correlated with fat-free mass. Mid- arm muscle area circumference had inverse relationship above(P<0.05). 6)Severe malnurished patients(SGA-C group) had lower result compared to mild-moderate malnurished patients(SGA-B group) about %TBF, LF,TF, total lymphocyte count. In addition to DEXA, we examined triceps skinfold thickness and mid-arm muscle area circumference. The result showed significant comparison between two groups, too. But albumin, cholesterol, potassium level was no statistical significant difference, except lymphcyte count. In conclusion, as suggested by above results, chronic renal failure patients has protein-calorie malnutrition. This nutritional status affects long-term survival of chronic renal failure patients. DEXA can give objective data accompanied with simple anthropometric measurement in nutriti onal status. Thus, we recommend DEXA as objective method of nutritional examination. In future, more precise method will be discovered, and that contribute more long-term survival of chronic renal failure patients.