scholarly journals Bioelectrical Impedance Analysis–Derived Phase Angle Predicts Protein–Energy Wasting in Maintenance Hemodialysis Patients

2019 ◽  
Vol 29 (4) ◽  
pp. 295-301 ◽  
Author(s):  
Rong-shao Tan ◽  
Dan-hua Liang ◽  
Yan Liu ◽  
Xiao-shi Zhong ◽  
Dong-sheng Zhang ◽  
...  
2020 ◽  
Author(s):  
Masakazu Saitoh ◽  
Masumi Ogawa ◽  
Hisae Kondo ◽  
Kiichi Suga ◽  
Tetsuya Takahashi ◽  
...  

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.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Masakazu Saitoh ◽  
Masumi Ogawa ◽  
Hisae Kondo ◽  
Kiichi Suga ◽  
Tetsuya Takahashi ◽  
...  

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.


2020 ◽  
Author(s):  
Masakazu Saitoh ◽  
Masumi Ogawa ◽  
Hisae Kondo ◽  
Kiichi Suga ◽  
Tetsuya Takahashi ◽  
...  

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.


Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1745
Author(s):  
Cordelia-Kheng-May Lim ◽  
Jun-Hao Lim ◽  
Imliya Ibrahim ◽  
Yoke-Mun Chan ◽  
Nor Fadhlina Zakaria ◽  
...  

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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