Abstract
Early detection and regular monitoring of the nutritional status of patients with diabetic chronic kidney disease (DMCKD) with reliable tools are necessary. We aimed to determine the clinical significance of the phase angle (PhA) in patients with DMCKD stage 5 not undergoing dialysis. A total of 219 patients (non-diabetic CKD stage 5 [nDMCKD5], n = 84; diabetic CKD stage 5 [DMCKD5], n = 135) were analyzed. The nDMCKD5 group had a significantly higher PhA (p = 0.001), intracellular water/body weight (p = 0.001), and albumin level (p = 0.010) than the DMCKD5 group. The DMCKD5 group experienced significantly more overhydration (p < 0.001). The PhA was positively associated with the lean tissue index (LTI) (r = 0.332; p < 0.001), hemoglobin level (r = 0.223; p = 0.010), albumin level (r = 0.524; p < 0.001), and estimated glomerular filtration rate (eGFR; r = 0.204; p = 0.018) in the DMCKD5 group. Multivariate logistic regression analysis showed the eGFR (odds ratio [OR]: 0.824, 95% confidence interval [CI]: 0.698–0.974); p = 0.023), LTI (OR: 0.771, 95% CI: 0.642–0.926; p = 0.005), and albumin level (OR: 0.131, 95% CI: 0.051–0.338; p < 0.001) were significantly associated with undernutrition (PhA < 4.17°) in the DMCKD5 group. Our observations suggest that the PhA could be used as a marker to reflect the nutritional status in patients with DMCKD5.
Highlights
Diabetes or chronic kidney disease (CKD) could be contributing to a poor prognosis related to nutritional status even though the two diseases are common, heterogeneous, and multifactorial
Multivariate logistic regression analysis showed the estimated glomerular filtration rate (eGFR); p = 0.023), lean tissue index (LTI) (OR: 0.771, 95% confidence intervals (CI): 0.642–0.926; p = 0.005), and albumin level (OR: 0.131, 95% CI: 0.051–0.338; p < 0.001) were significantly associated with undernutrition (PhA < 4.17◦ ) in the DMCKD5 group
Our observations suggest that the phase angle (PhA) could be used as a marker to reflect the nutritional status in patients with DMCKD5
Summary
Diabetes or chronic kidney disease (CKD) could be contributing to a poor prognosis related to nutritional status even though the two diseases are common, heterogeneous, and multifactorial. The prognosis for patients with diabetic chronic kidney disease (DMCKD) is considered to be worse than that for either disease individually. Many nutritional assessment tools have been introduced. Studies on the PhA have been published in the area of kidney disease [5,6,7]. Previous PhA studies only included patients undergoing hemodialysis or peritoneal dialysis. Pre-dialysis CKD studies have been performed on an extensive group of patients in all disease stages. Reports that have evaluated and compared the nutritional status and body composition between non-diabetic
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