Estimation of total-body and limb muscle mass in hemodialysis patients by using multifrequency bioimpedance spectroscopy

Abstract

Background: Skeletal muscle mass can be measured noninvasively with magnetic resonance imaging (MRI), but this is time-consuming and expensive. Objective: We evaluated the use of multifrequency bioimpedance spectroscopy (BIS) measurements of intracellular volume (ICV) to model total-body skeletal muscle mass (TBMM) and limb skeletal muscle mass in hemodialysis patients. Design: TBMM was measured by MRI in 20 male and 18 female hemodialysis patients with a median (range) age of 54 y (33–73 y), weight of 78.9 kg (43.2–120 kg), and body mass index (BMI; in kg/m²) of 27.3 (19.4–46.6). We measured total body water (TBW) by using D₂O dilution, extracellular volume (ECV) as bromide space, and ICV as TBW minus bromide space. Total body potassium (TBK) measured as ⁴⁰K was used as an independent model of TBMM. BIS was used to measure whole-body TBW (ankle to wrist) and TBW in the arms and legs. BIS-estimated ICV was used to construct models to calculate limb muscle mass and TBMM. The latter was compared with models derived from isotopic methods. Results: BIS yielded a model for TBMM [TBMM = 9.52 + 0.331 × ICV + 2.77 (male) + 0.180 × weight (kg) − 0.133 × age] (R² = 0.937, P < 0.0001) as precise as TBK-measured TBMM [TBMM = 1.29 + 0.00453 × TBK (mEq) + 1.46 (male) + 0.144 × weight (kg) − 0.0565 × age] (R² = 0.930, P < 0.0001) or isotopic methods. BIS models were also developed for measuring leg and arm muscle mass. Conclusion: BIS provides an estimate of TBMM that correlates well with isotopic methods in approximating values obtained by MRI and can be used to estimate limb muscle mass.