scholarly journals Phase angle values, a good indicator of nutritional status, are associated with median value of hemoglobin rather than hemoglobin variability in hemodialysis patients

Renal Failure ◽  
2021 ◽  
Vol 43 (1) ◽  
pp. 327-334
Author(s):  
Do Hyoung Kim ◽  
Dong-Jin Oh
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Hemodialysis Patients ◽  
Hemoglobin Variability

scholarly journals Relação dos Parâmetros Derivados da Bioimpedância Elétrica com o Estado Nutricional de Pacientes em Hemodiálise

2017 ◽  
Vol 21 (2) ◽  
pp. 98
Author(s):  
Marilia Firmino De Castro Ribeiro ◽  
Juliana Megumi Nisio dos Reis ◽  
Ana Paula Bazanelli
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Negative Correlation ◽  
Cell Mass ◽  
Bioelectrical Impedance ◽  
Hemodialysis Patients ◽  
The Body ◽  
Body Cell Mass ◽  
Body Cell ◽  
The Mean

Os parâmetros não tradicionais derivados da bioimpedância elétrica (BIA) como reatância, ângulo de fase e massa celular estão cada vez sendo mais utilizados na prática clínica para auxiliar no diagnóstico nutricional dos pacientes com doença renal crônica e, consequentemente, no prognóstico clínico dessa população. O presente estudo teve por objetivo avaliar a relação dos parâmetros derivados da BIA com o estado nutricional de pacientes em hemodiálise. Estudo transversal, realizado com trinta pacientes adultos de uma clínica de Nefrologia localizada na região metropolitana de São Paulo. Foi utilizada a BIA para avaliar esses parâmetros, assim como para avaliar a composição corporal. A amostra foi constituída por homens e mulheres com média de idade de aproximadamente 56 anos. O ângulo de fase dos pacientes foi de 5,9±1,6 graus e apresentou uma correlação negativa com idade (r= -0,69, p< 0,001) e água corporal extracelular (r= -0,93 p< 0,001). A média de reatância foi de 50,9±16,08 ohms e apresentou correlação negativa com a água extracelular (r= -0,82, p<0,001) e positiva com a massa celular (r=0,51, p<0,004). Em relação ao percentual de massa celular, a média foi de 36,8± 6,1%, sendo que a mesma apresentou uma correlação negativa com a idade (r= -0,66, p< 0,001), gordura corporal (r= -0,73, p< 0,001), água corporal extracelular (r= -0,82, p<0,001).Conclui-se que os parâmetros não tradicionais derivados da BIA apresentaram boa associação com o estado nutricional dos pacientes, podendo dessa forma, serem aliados importantes para obtenção do melhor diagnóstico nutricional e, consequentemente, do prognóstico dos mesmos durante o tratamento dialítico.Palavras-chave: Bioimpedância Elétrica. Estado Nutricional. Diálise.AbstractNon-traditional parameters derived from bioelectrical impedance analysis (BIA) as reactance, phase angle and cell mass are increasingly being used in clinical practice to improve the nutritionalstatus of chronic kidney disease patients andthe clinical outcomes in this population. The present study aimed to evaluate the relationship of parameters derived from the BIA with nutritional status of hemodialysis patients. It was a cross-sectional study with 30 adultspatients of a nephrology clinic in the metropolitan region of São Paulo. BIA was used to evaluate as well as to assess the body composition. The mean age of the patients was approximately 56 years. The phase angle of the patients was 5.9 ± 1.6 degrees and it was negatively correlated with age (r = -0.69, p <0.001) andwith extracellular body water (r = -0.93 p <0.001). The mean reactance was 50.9 ± 16.08 ohms and it showed a negative correlation with the extracellular water (r = -0.82, p <0.001) and positively with the body cell mass (r = 0.51, p <0.004). Regarding to the percentage of body cell mass, the mean was 36.8 ± 6.1%, and it presented a negative correlation with age (r = -0.66, p <0.001), body fat (r = -0.73, p <0.001) and with body water extracellular (r = -0.82, p <0.001). The present study concluded that non-traditional parameters derived from BIA showed a good association with the nutritional status of hemodialysis patients. It is important for getting the best nutritional diagnosis and consequently the prognosis of these patientsduring the dialysis treatment.Keywords: Bioelectrical Impedance. Nutritional Status. Dialysis.

The Phase Angle and Mass Body Cell as Markers of Nutritional Status in Hemodialysis Patients

2010 ◽  
Vol 20 (5) ◽  
pp. 314-320 ◽  
Author(s):  
Claudia M.C. Oliveira ◽  
Marcos Kubrusly ◽  
Rosa S. Mota ◽  
Carlos A.B. Silva ◽  
Gabriel Choukroun ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Hemodialysis Patients ◽  
Body Cell

The Effects of Oral Energy-Dense Supplements on Nutritional Status in Nondiabetic Maintenance Hemodialysis Patients

2021 ◽  
pp. CJN.16821020
Author(s):  
Yaya Yang ◽  
Xianhui Qin ◽  
Junzhi Chen ◽  
Qi Wang ◽  
Yaozhong Kong ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Nutritional Supplement ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Dietary Energy ◽  
Short Term ◽  
Dietary Energy Intake

Background and objectives: Fat-based energy-dense nutritional supplements may offer benefits over protein or carbohydrate dense supplements for patients receiving dialysis because of the adverse metabolic consequences of the latter. We conducted a randomized controlled trial to assess the effects of the short-term use of a fat-based nutritional supplement on various measures of nutritional status in patients receiving maintenance hemodialysis who have low dietary energy intake. Design, setting, participants, and measurements: We enrolled nondiabetic patients receiving hemodialysis for more than 3 months and had inadequate dietary energy intake (<30kcal/kg/d). The participants were randomly assigned in a 1:1 ratio to receive an oral fat-based energy-dense supplement (300kcal daily) or routine care for 12 weeks (n=120 per group). The primary outcome was the change in phase angle, measured by bioelectrical impedance analysis, a marker of cell integrity and body cell mass, from the baseline to week 12. The secondary outcomes were changes in quality of life. Other outcomes included laboratory nutritional indicators and physical examinations. Results: The average age of the total population was 47 (SD: 12) years and 55% were male. The median of dialysis vintage was 43.4 (22.5, 76.3) months. 240 participants were randomly assigned to the intervention (n=120) or control group (n=120). In total, 228 (95%) participants completed the trial. The change in phase angle did not differ significantly between the intervention and the control groups (estimate (95% confidence interval [CI]): 0.0 (-0.1, 0.1) vs. 0.0 (-0.1, 0.1); estimated difference, 0.0; 95% [CI], −0.2 to 0.2; P=0.99). None of the 19 domains of quality of life differed between the groups. Adverse events were reported in 23 (19%) participants in the control group and 40 (33%) participants in the intervention group. Conclusions: In nondiabetic maintenance hemodialysis patients, short-term administration of fat-based energy-dense nutritional supplement has no clinically significant effect on nutritional status as measured by phase angle.

scholarly journals P0948ASSOCIATION OF PHASE ANGLE WITH NUTRITION, MORTALITY, MAJOR ADVERSE CARDIOVASCULAR EVENTS AND SARCOPENIA IN MAINTENANCE HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Eunjin Bae ◽  
Tae Won Lee ◽  
Ha Nee Jang ◽  
Hyun Seop Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Phase Angle ◽  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Major Adverse Cardiovascular Events ◽  
Maintenance Hemodialysis ◽  
Lower Phase ◽  
All Cause Mortality ◽  
History Of ◽  
Maintenance Hemodialysis Patients

Abstract Background and Aims Nutrition has been consistently important in end stage renal disease patients. However, it is difficult to obtain adequate nutritional status while avoiding fluid overload, hyperphosphatemia and hyperkalemia in hemodialysis patients. In addition, there is no golden standard for diagnosing protein energy wasting (PEW) in maintenance hemodialysis patients. We studied the clinical significance of phase angle using bioelectrical impedance analysis (BIA), one of the PEW diagnostic tools, to predict various clinical outcomes in maintenance hemodialysis patients. Method We retrospectively enrolled patients who received hemodialysis for more than 3 months from 2016 to March 2019, excluding patients had active cancer, or died within 30 days, had no BIA data. We evaluated the factors related phase angle and the role of phase angle as predictors of all-cause mortality and major adverse cardiovascular events (MACE), sarcopenia. Results Of 191 patients, 63.4% were men, mean age was 64.2 ± 12.4 years, mean body mass index (BMI) was 23.8 ± 6.9 kg/m2, and the most common underlying disease were hypertension and diabetes mellitus. Lower phase angle group (phase angle ≤4°) patients had older age, higher portion of women, malnourished, and history of coronary artery disease (CAD) than higher phase angle group (phase angle &gt;4°) patients. Phase was significantly related with nutritional parameters. During a median follow up of 16.7 months, 14.1% (n=27) patients experienced a MACE, 11.0% (n=21) patients died. In multivariate Cox analyses, lower phase angle, higher CRP level and history of CAD were significantly related with all-cause mortality even after adjustment for covariates. However, phase angle was not significantly associated with MACE and sarcopenia. Conclusion In maintenance hemodialysis patients, phase angle was significantly related to mortality as well as nutritional status, but MACE and sarcopenia were not. Clinicians should be careful to find and treat correctable factors with low phase angle and high CRP level in maintenance hemodialysis patients.

P1583UTILITY OF THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION CRITERIA FOR THE DETECTION OF MALNUTRITION AND DECLINE IN PHYSICAL FUNCTION AND ADL IN JAPANESE AMBULATORY HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Haruka Ito ◽  
Shohei Yamamoto ◽  
Manae Harada ◽  
Takaaki Watanabe ◽  
Yuta Suzuki ◽  
...  
Keyword(s):  
Physical Function ◽  
Phase Angle ◽  
Handgrip Strength ◽  
Hemodialysis Patients ◽  
Global Leadership ◽  
Analysis Of Covariance ◽  
Nutritional Risk ◽  
Calf Circumference ◽  
Risk Of Death ◽  
Cumulative Score

Abstract Background and Aims In patients who undergo hemodialysis (HD), malnutrition is a frequent complication associated with higher risk of death, extended hospital stay, physical limitation, and decline of activities of daily living (ADL). Therefore, proper assessment for malnutrition in this population is important for effective disease management. The Global Leadership Initiative on Malnutrition (GLIM) released new criteria for diagnosing and grading malnutrition. Nevertheless, only very few studies have investigated malnutrition prevalence on the basis of the GLIM criteria in hemodialysis patients. Hence, the usefulness of the GLIM criteria’s application in hemodialysis patients remains unclear. The aims of this study were (1) to examine whether malnutrition diagnosed on the basis of the GLIM criteria will produce equivalent results with that diagnosed with the use of existing nutritional indicators and (2) to evaluate the association between the GLIM criteria and decline of physical function and ADL in Japanese patients on HD. Method This cross-sectional study included a total of 185 outpatients who undergo HD three times a week. We measured the existing nutritional indicators (GNRI, MNA-SF, phase angle, mid-arm muscle circumference, and calf circumference), physical function (Fried Scale, handgrip strength, usual gait speed, Short Physical Performance Battery, and physical activity), and ADL status (cumulative score of Barthel Index and instrumental ADL). On the basis of the GLIM criteria, the patients were classified into two groups (no malnutrition and malnutrition). In addition, in case of nutritional risk, nutritional assessment was performed by evaluation of the phenotypic (unintentional weight loss, low BMI, and/or reduced muscle mass) and etiologic (reduced intake or assimilation and/or inflammatory response) factors. Malnutrition was diagnosed if a patient has one or more of these items. The analysis of covariance (ANCOVA) was performed to examine the association between the GLIM criteria and existing nutritional indicators, physical function, and ADL status. Results Malnutrition was diagnosed in 41.1% of the participants based on the GLIM criteria. In contrast, on the basis of the existing nutritional indicators (GNRI, MNA-SF, phase angle, mid-arm muscle circumference, and calf circumference), malnutrition was diagnosed in 22.2%, 58.3%, 48.6%, 57.9%, and 54.6%, respectively. The ANCOVA results, adjusted for the patient’s characteristics, revealed that the malnutrition group had significantly lower score than the non-malnutrition group in the existing nutritional indicators (all P &lt; 0.001) (Figure). Furthermore, the malnutrition group had significantly higher Fried Scale scores, lower handgrip strength results, and lower ADL status than the non-malnutrition group, even after potential confounder adjustment (all P &lt; 0.05). Conclusion The GLIM criteria could be one of the useful tools for screening the risk of malnutrition, frailty, lower handgrip strength, and lower ADL status in patients who undergo HD.

L-carnitine infusions may suppress serum C-reactive protein and improve nutritional status in maintenance hemodialysis patients

2005 ◽  
Vol 15 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Vincenzo Savica ◽  
Domenico Santoro ◽  
Giampiero Mazzaglia ◽  
Franco Ciolino ◽  
Paolo Monardo ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Maintenance Hemodialysis Patients

scholarly journals Comparison of Simplified Creatinine Index and Systemic Inflammatory Markers for Nutritional Evaluation of Hemodialysis Patients

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1870
Author(s):  
Ming-Tsun Tsai ◽  
Wei-Cheng Tseng ◽  
Shuo-Ming Ou ◽  
Kuo-Hua Lee ◽  
Chih-Yu Yang ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Body Mass ◽  
Inflammatory Markers ◽  
Risk Index ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Fat Free Mass ◽  
Screening Tools ◽  
Composition Analysis ◽  
Nutritional Risk Index

Protein-energy wasting (PEW) is associated with adverse outcomes in hemodialysis patients. This study compares the simplified creatinine index (SCI) and circulating inflammatory markers as nutritional screening tools for hemodialysis patients. Maintenance hemodialysis patients (230 total patients, 34.8% women, 64.0 ± 14.3 years old) from a tertiary medical center were assessed for demographic data, body composition analysis, biochemistry tests, and circulating inflammatory biomarkers. The SCI was calculated using Canaud’s formula. Reduced fat-free mass index (FFMI), a surrogate of lean body mass, was identified according to the European Society for Clinical Nutrition and Metabolism guidelines. Nutritional status was assessed by the geriatric nutritional risk index (GNRI) and International Society of Renal Nutrition and Metabolism (ISRNM) criteria. Multivariate logistic regression revealed independent risk factors for low FFMI and malnutrition. Of the patients, 47.4% had low FFMI. Patients with a reduction in FFMI tended to be older females with lower body mass index, SCI, and GNRI scores but significantly higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and IL-8. SCI was found to be an independent predictor for reduced FFMI (OR 0.57, 95% CI 0.40–0.81) and presence of PEW according to ISRNM criteria (OR 0.38, 95% CI 0.21–0.68). Although a positive association between systemic inflammatory markers and low FFMI was observed, this association disappeared in multivariate analysis. Moreover, the inflammatory markers examined in this study were not associated with malnutrition after adjusting for potential confounders. Compared with markers of systemic inflammation, SCI achieved better performance in assessing the nutritional status of hemodialysis patients.

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