ArticleFrontiers in nutrition2026
The role of fat-free mass index in evaluating protein-energy wasting in maintenance hemodialysis patients: a multicenter cross-sectional study.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Protein-energy wasting (PEW) is prevalent in maintenance hemodialysis (MHD) patients and associated with poor outcomes. This study aimed to evaluate the agreement of fat-free mass index (FFMI) measured by bioelectrical impedance analysis (BIA) with conventional nutritional tools and to explore its potential value as a supplementary screening measure for PEW in MHD patients. Methods: In this multicenter cross-sectional study, 272 MHD patients were enrolled between April 2016 and October 2019. Body composition was assessed using a multifrequency BIA device capable of segmental and whole-body composition analysis. Patients were classified into low or normal FFMI groups based on established sex-specific criteria (FFMI < 17 kg/m Results: The mean age of participants was 58.8 ± 12.7 years, with a mean FFMI of 16.6 ± 2.2 kg/m Conclusion: Conventional nutritional assessment tools, including ALB, BMI, NRS2002, and SGA, frequently fail to detect low muscle mass in MHD patients. FFMI derived from BIA provides an objective, non-invasive, and potentially useful measure that may aid in the screening of PEW, particularly in detecting low muscle mass that is often missed by conventional tools. We recommend the integration of BIA-based body composition analysis as a supplementary tool into routine nutritional management of hemodialysis patients to enable timely interventions.
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