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Assessment of body composition in ESRF.

To the Editor: We read with interest the recent article of Cooper et al, in which they proposed hand-to-feet bioelectrical impedance analysis (BIA) as an accurate and very useful surrogate marker for total body water (TBW) in patients with end-stage renal failure (ESRF)1. Despite this assertion, the authors also acknowledged that a great variation existed between TBW assessed by BIA compared to the gold standard (deuterium oxide) technique (-10.9 to 8.4 L). This wide variation is in agreement with our very recent findings (unpublished data), in which we also found a significant discrepancy between TBW assessed by multifrequency BIA and deuterium oxide (-3.4 to 20.3 l) in 18 patients with hemodialysis, and that BIA tended to underestimate TBW.