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Cited by 207Body Composition Measurement TechniquesLiver Disease and TransplantationNutrition and Health in Aging

Bioelectrical Impedance Analysis Is A Useful Bedside Technique to Assess Malnutrition in Cirrhotic Patients With and Without Ascites

Pirlich, Matthias, Schütz, Tatjana, Spachos, Theo, Ertl, Siegfried, WeiΒ, Marie-Luise, Lochs, Herbert, Plauth, Mathias·2000·Hepatology
DOI 10.1053/jhep.2000.20524
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Abstract

Protein–calorie malnutrition is associated with poor prognosis in chronic liver disease, but reliable assessment is hampered by changes in body water. We prospectively evaluated the effect of fluid retention on bioelectrical impedance analysis (BIA) as a simple method for the estimation of body cell mass (BCM BIA) in 41 patients with cirrhosis (n = 20 with ascites; n = 21 without ascites) using total body potassium counting (BCM TBP) as a reference method. Arm muscle area and creatinine–derived lean body mass were compared with total body potassium data. In patients total body potassium was 24.4% lower than in controls and this loss was more severe in patients with ascites (-34.1%; P < .01). BCM BIA and BCM TBP were closely correlated in controls (r 2 = .87, P < .0001), patients without ascites (r 2 = .94, P < .0001) and patients with ascites (r 2 = .56, P < .0001). Removal of 6.2 ± 3 L of ascites had only minor effects on BCM BIA (deviation of -0.18 kg/L ascites). Limits of agreement between both methods were wider in patients with ascites than in patients without (6.2 vs. 4.2 kg). In patients without ascites arm muscle area (r 2 = .64; P < .001) and lean body mass (r 2 = .55; P < .001) correlated significantly with total body potassium, but not in patients with ascites. For assessment of protein malnutrition in patients with cirrhosis, body cell mass determination by use of BIA offers a considerable advantage over other widely available but less accurate methods like anthropometry or the creatinine approach. Despite some limitations in patients with ascites, BIA is a reliable bedside tool for the determination of body cell mass in cirrhotic patients with and without ascites.

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  • In patients with liver cirrhosis, decreased total body potassium and creatinine excretion correlate with bioelectrical impedance analysis, while body weights are relatively well preserved due to water retention.

    “In studies in patients with liver cirrhosis, decreased total body potassium and creatinine excretion were found, correlating with the results of bioelectrical impedance analysis, while body weights were relatively well preserved due to water retention.20”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [20]

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Authors
Pirlich, M., Schütz, T., Spachos, T., Ertl, S., WeiΒ, M.-L., Lochs, H., & Plauth, M.
Affiliations
  • Charité – Universitätsmedizin Berlin (DE)
  • Humboldt-Universität zu Berlin (DE)
ORCID
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2000-12
Volume
32
Issue
6
Pages
1208-1215
ISSN
0270-9139 (ISSN-L)
DOI
10.1053/jhep.2000.20524
OpenAlex
W2018875174
Cited by
207
References
39
Citations by year
2026: 3 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 7 · 2021: 7 · 2020: 15 · 2019: 10 · 2018: 12 · 2017: 13 · 2016: 8 · 2015: 10 · 2014: 9 · 2013: 8 · 2012: 13
FWCI
3.67
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 5387 d)
Locations
  • Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Keywords
bioelectrical impedance analysis, malnutrition, liver cirrhosis, ascites, protein-energy malnutrition, body cell mass, total body potassium, fluid retention, arm muscle area, lean body mass, bedside assessment
MeSH terms
Adult, Anthropometry, Ascites, Creatinine, Female, Humans, Liver Cirrhosis, Male, Middle Aged, Potassium, Prospective Studies, Protein-Energy Malnutrition, Thinness, Electric Impedance, Point-of-Care Systems

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