Development and validation of a multifrequency bioimpedance spectroscopy equation to predict appendicular skeletal muscle mass in hemodialysis patients
Abstract
Background & aims The Body Composition Monitor (BCM), a multifrequency bioimpedance spectroscopy device, has been widely used to assess body composition in hemodialysis patients because its measurement is not affected by overhydration commonly seen in chronic kidney disease. We aimed to develop and validate an equation for obtaining appendicular skeletal muscle mass (ASM) from BCM taking dual-energy X-ray absorptiometry (DXA) as the reference among hemodialysis patients.Methods A total of 322 consecutive body composition measurements with BCM and DXA in 263 hemodialysis patients were randomly divided at a ratio of 2:1 into development and validation groups. Stepwise multiple regression modeling was applied to develop the ASM prediction equation. We evaluated the model as a diagnostic tool for sarcopenia using cutoffs of ASM defined by the Asian Working Group for Sarcopenia (AWGS). We further explored the association between ASM predicted by the BCM equation and all-cause mortality in two independent cohorts: one with 326 stage 3-5 CKD patients and one with 629 hemodialysis patients.Results BCM yielded the following equation: ASM (kg) = -1.838 + 0.395 × total body water (L) + 0.105 × body weight (kg) + 1.231 × male sex - 0.026 × age (years) (R 2 = 0.914, standard error of estimate = 1.35 kg). In the validation group, Bland-Altman reliability analysis showed no significant bias of 0.098 kg and limits of agreement ±2.440 kg. Using the AWGS criteria, the model was found to have a sensitivity of 94.1%, a specificity of 98.8%, a positive predictive value of 84.2%, and a negative predictive value of 99.6% for the diagnosis of sarcopenia. Low ASM predicted by the BCM equation was associated with significantly worse overall survival among CKD patients but not hemodialysis patients.Conclusions The new BCM equation provides a feasible and valid option for assessing ASM in hemodialysis patients.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Regarding foot-to-hand technology for people with diseases, three equations are for appendicular LSM in frail, chronic kidney, or hemodialysis male and female subjects.
“Regarding the foot to hand technology, there is one equation suitable for assessing FFM in overweight and obese postmenopausal females [98], four for appendicular FM and FFM in functionally limited male and female individuals [40], four for assessing FFM in amputee males [41], one for predicting TBW in anorexic females [56], and three for appendicular LSM in frail [64], chronic kidney [65], or hem”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [99]
The citation lists haven’t been fetched yet
References 33 · Cited by 54
- Authors
- Lin, T.-Y., Wu, M.-Y., Chen, H.-S., Hung, S.-C., & Lim, P.-S.
- Affiliations
- Tzu Chi University (TW)
- Tungs' Taichung MetroHarbor Hospital (TW)
- Corresponding author
- Hung, Szu-Chun
- Lim, Paik-Seong
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 40
- Issue
- 5
- Pages
- 3288-3295
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W3097034677
- Cited by
- 54
- References
- 33
- Citations by year
- 2026: 5 · 2025: 16 · 2024: 16 · 2023: 10 · 2022: 6 · 2021: 1
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Taipei Tzu Chi Hospital
- Ministry of Science and Technology
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- appendicular skeletal muscle mass, body composition monitor, hemodialysis patients, sarcopenia, chronic kidney disease, prediction equations, dual-energy X-ray absorptiometry, all-cause mortality, fluid overload
- MeSH terms
- Body Composition, Female, Renal Dialysis, Humans, Kidney Failure, Chronic, Male, Middle Aged, Reproducibility of Results, Absorptiometry, Photon, Electric Impedance, Muscle, Skeletal, Sarcopenia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
