SUN-P118: Phase Angle is a Useful Diagnostic Parameter in a Comprehensive Assessment of Protein-Energy Wasting in Haemodialysis Patients

Abstract Background: 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. The aim of this study is to determine whether BIA-derived PA is a marker of PEW or frailty in HD patients.Methods: This 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.Results: The 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.Conclusions: Lower PA was associated with a greater risk of PEW and frailty in HD patients.

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Bioelectrical impedance analysis-derived phase angle as a determinant of protein-energy wasting and frailty in maintenance hemodialysis patients: retrospective cohort study

BMC Nephrology ◽

10.1186/s12882-020-02102-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Masakazu Saitoh ◽

Masumi Ogawa ◽

Hisae Kondo ◽

Kiichi Suga ◽

Tetsuya Takahashi ◽

...

Keyword(s):

Phase Angle ◽

Bioelectrical Impedance Analysis ◽

Multivariate Logistic Regression Analysis ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Hemodialysis Patients ◽

Cardiovascular Health Study ◽

Protein Energy Wasting ◽

Protein Energy ◽

Quartile Group

Abstract Background 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. The aim of this study is to determine whether BIA-derived PA is a marker of PEW or frailty in HD patients. Methods This 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. Results The 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. Conclusions Lower PA was associated with a greater risk of PEW and frailty in HD patients.

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Bioelectrical Impedance Analysis-derived Phase Angle as a Determinant of Protein-energy Wasting and Frailty in Maintenance Hemodialysis Patients: retrospective cohort study

10.21203/rs.3.rs-38723/v3 ◽

2020 ◽

Author(s):

Masakazu Saitoh ◽

Masumi Ogawa ◽

Hisae Kondo ◽

Kiichi Suga ◽

Tetsuya Takahashi ◽

...

Keyword(s):

Phase Angle ◽

Bioelectrical Impedance Analysis ◽

Multivariate Logistic Regression Analysis ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Hemodialysis Patients ◽

Cardiovascular Health Study ◽

Protein Energy Wasting ◽

Protein Energy ◽

Quartile Group

Abstract Background: 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. The aim of this study is to determine whether BIA-derived PA is a marker of PEW or frailty in HD patients.Methods: This 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.Results: The 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. Conclusions: Lower PA was associated with a greater risk of PEW and frailty in HD patients.

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Bioelectrical Impedance Analysis Derived-Phase Angle as a Pragmatic Tool to Detect Protein Energy Wasting among Multi-Ethnic Hemodialysis Patients

Diagnostics ◽

10.3390/diagnostics11101745 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1745

Author(s):

Cordelia-Kheng-May Lim ◽

Jun-Hao Lim ◽

Imliya Ibrahim ◽

Yoke-Mun Chan ◽

Nor Fadhlina Zakaria ◽

...

Keyword(s):

Phase Angle ◽

Bioelectrical Impedance Analysis ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Test Accuracy ◽

Protein Energy Wasting ◽

Metabolic Derangement ◽

Discriminative Performance ◽

Protein Energy ◽

Gender Specific

Protein-energy wasting (PEW) is a devastating metabolic derangement that leads to increased morbidity and mortality in hemodialysis (HD) patients. This study aimed to determine the diagnostic test accuracy of bioelectrical impedance analysis derived-phase angle (PhA) in detecting PEW among HD patients. This was a multi-centre, cross-sectional study conducted amongst 152 multi-ethnic HD patients in Klang Valley, Malaysia. PEW was assessed using the International Society of Renal Nutrition and Metabolism criteria as the reference method. PhA was measured using a multi-frequency bioelectrical impedance spectroscopy at 50 kHz. Multiple and logistic regressions were used to determine factors associated with PhA and PEW diagnosis, respectively. A receiver operating characteristics curve analysis was used to establish the gender-specific PhA cut-offs to detect PEW. PEW existed in 21.1% of the HD patients. PhA was found as an independent predictor of PEW (adjOR = 0.308, p = 0.001), with acceptable to excellent discriminative performance (adjAUCmale = 0.809; adjAUCfemale = 0.719). Male patients had higher PhA cut-off compared to female patients (4.26° vs. 3.30°). We concluded that PhA is a valid and pragmatic biomarker to detect PEW in multi-ethnic Malaysian HD patients and a gender-specific cut-off is necessary, attributed to the gender differences in body composition.

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Bioelectrical Impedance Analysis-derived Phase Angle as a Determinant of Protein-energy Wasting and Frailty in Maintenance Hemodialysis Patients: retrospective cohort study

10.21203/rs.3.rs-38723/v2 ◽

2020 ◽

Author(s):

Masakazu Saitoh ◽

Masumi Ogawa ◽

Hisae Kondo ◽

Kiichi Suga ◽

Tetsuya Takahashi ◽

...

Keyword(s):

Phase Angle ◽

Cardiovascular Health ◽

Multivariate Logistic Regression Analysis ◽

Japanese Version ◽

Health Study ◽

Cardiovascular Health Study ◽

Maintenance Hemodialysis ◽

Protein Energy Wasting ◽

Protein Energy ◽

Quartile Group

Abstract Background To evaluate the relationship between phase angle (PA) measured by bioimpedance electrical analysis and protein-energy wasting (PEW) or frailty, and its impact on 2-year mortality in patients with hemodialysis (HD). Methods This 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 (quartile 1, lowest; quartile 4, highest). 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. Results The 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 (PA<3.7 ° ) was at a significantly greater risk of both PEW and frailty compared with the fourth quartile group (PA≥5.0 ° ) after adjusting for other confounding factors. Conclusions Lower PA was associated with a greater risk of PEW and frailty in HD patients.

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Chronic kidney disease. Protein energy wasting. Nutritional assessment. Phase angle. Mid arm circumference.

Nutrición Hospitalaria ◽

10.20960/nh.2463 ◽

2019 ◽

Author(s):

Iván Armando Osuna Padilla ◽

Gabriela Leal Escobar ◽

Karla Berenice Cano Escobar ◽

Bernardo Moguel González ◽

Héctor Alejandro Pérez Grovas ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Phase Angle ◽

Nutritional Assessment ◽

Protein Energy Wasting ◽

Protein Energy ◽

Arm Circumference ◽

Disease Protein

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Bioelectrical Impedance Analysis-derived Phase Angle as a Determinant of Protein-energy Wasting, Frailty, and Worse Outcome in Maintenance Hemodialysis Patients: retrospective cohort study

10.21203/rs.3.rs-38723/v1 ◽

2020 ◽

Author(s):

Masakazu Saitoh ◽

Masumi Ogawa ◽

Hisae Kondo ◽

Kiichi Suga ◽

Tetsuya Takahashi ◽

...

Keyword(s):

Regression Analysis ◽

Phase Angle ◽

Prognostic Significance ◽

Cardiovascular Health Study ◽

Protein Energy Wasting ◽

Cox Regression Analysis ◽

Protein Energy ◽

All Cause Mortality ◽

Quartile Group ◽

Fourth Quartile

Abstract Background To evaluate the relationship between phase angle (PA) measured by bioimpedance electrical analysis and protein-energy wasting (PEW) or frailty, and its impact on 2-year mortality in patients with hemodialysis (HD). Methods This 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 (quartile 1, lowest; quartile 4, highest). 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. Results The 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 (PA < 3.7°) was at a significantly greater risk of both PEW and frailty compared with the fourth quartile group (PA ≥ 5.0°) after adjusting for other confounding factors. In addition, Kaplan-Meier survival analysis showed a worse survival rate in the first quartile group than in the third quartile group (PA4.2-5.0°) and fourth quartile group (Log-rank test p = 0.05, respectively). The Cox regression analysis found that the first quartile group had a significantly greater risk of all-cause mortality than the patients in the fourth quartile group (HR 5.461 95%CI 1.180–25.280). Conclusions Lower PA was associated with a greater risk of PEW and frailty and found to have prognostic significance for 2-year all-cause mortality in HD patients.

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