Abstract
BackgroundPhase angle (PA), measured by bioelectrical impedance analysis (BIA) has been studied as indicator of nutritional status or muscle function in hemodialysis (HD) patients. It remains unclear if the phase angle is associated protein-energy wasting (PEW) or frailty, which are common complication in hemodialysis patients. The aim of this study is to determine whether BIA-derived PA is a marker of PEW or frailty in HD patients.MethodsThis retrospective observational study included 116 adult HD patients (35% female, 64 ± 12 years of age) in a single dialysis center. Patients were classified according to the PA quartiles into four groups; 1) first quartile: PA < 3.7°, 2) second quartile: PA 3.7–4.1°, 3) third quartile: PA 4.2–4.9°and 4) forth quartile: PA ≥ 5.0°. International Society of Renal Nutrition and Metabolism (ISRNM) criteria and Japanese version of Cardiovascular Health Study (J-CHS) criteria were used to identify PEW and frailty.ResultsThe lower PA group was associated with a greater risk of PEW (35% vs. 24% vs. 21% vs. 3%; p = 0.032), frailty (59% vs. 40% vs. 21% vs. 3%; p < 0.001). In multivariate logistic regression analysis, the first quartile group was at a significantly greater risk of both PEW and frailty compared with the fourth quartile group after adjusting for other confounding factors.ConclusionsLower PA was associated with a greater risk of PEW and frailty in HD patients.
Highlights
Phase angle (PA), measured by bioelectrical impedance analysis (BIA) has been studied as indicator of nutritional status or muscle function in hemodialysis (HD) patients
This study focused on HD patients, primarily to investigate the validity of BIA-derived PA in predicting protein-energy wasting (PEW) and frailty, and secondly to examine the association between PA and cardiovascular event (CV) risk
Our findings demonstrated that 35% of patients in the first quartile group, 24% in the second quartile group, 21% in the third quartile group, and 3% in the fourth quartile group exhibited PEW based on International Society of Renal Nutrition and Metabolism (ISRNM) criteria (p = 0.032)
Summary
Phase angle (PA), measured by bioelectrical impedance analysis (BIA) has been studied as indicator of nutritional status or muscle function in hemodialysis (HD) patients. It remains unclear if the phase angle is associated protein-energy wasting (PEW) or frailty, which are common complication in hemodialysis patients. Phase angle is a direct measure of BIA and not influenced by assumptions that can affect body composition or hydration assessments. This study focused on HD patients, primarily to investigate the validity of BIA-derived PA in predicting PEW and frailty, and secondly to examine the association between PA and CV risk
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