Bioelectrical impedance analysis–derived phase angle predicts sarcopenia in patients on maintenance hemodialysis

Abstract

Background This study aimed to investigate the association between phase angle (PhA) and sarcopenia and evaluate its performance as a sarcopenia predictor in patients receveing maintenance hemodialysis (MHD). Methods All enrolled patients underwent handgrip strength (HGS) and the 6‐m walk test, and muscle mass was measured using bioelectrical impedance analysis. Sarcopenia was diagnosed according to the diagnostic criteria of the Asian Sarcopenia Working Group. Logistic regression analysis was used to evaluate the PhA as an independent predictor of sarcopenia after adjusting for confounding factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of PhA in sarcopenia. Results Two hundred forty‐one patients receiving hemodialysis were enrolled in this study, and the prevalence of sarcopenia was 28.2%. Patients with sarcopenia presented a lower PhA value (4.7° vs 5.5°; P < 0.001), lower muscle mass index (6.0 vs 7.2 [kg/m2]; P < 0.001), lower HGS (19.7 vs 26.0 [kg]; P < 0.001), and lower walk speed (0.83 ± 0.27 vs 0.92 ± 0.23 [m/s]; P = 0.007) than patients without sarcopenia. The odds of patients receiving MHD presenting with sarcopenia increased as PhA decreased, even after adjustment (odds ratio = 0.39; 95% CI, 0.18–0.85; P = 0.019). ROC analysis revealed that the best cutoff value of PhA for sarcopenia was 4.95° in patients receiving MHD. Conclusion PhA may be a useful and simple predictor for predicting patients undergoing hemodialysis who are at risk of sarcopenia. To further facilitate the application of PhA in the diagnosis of sarcopenia, more research need to be conducted.

Bioelectrical impedance analysis–derived phase angle predicts possible sarcopenia in patients on maintenance hemodialysis: A retrospective study

“…However, the SMI was used to evaluate the muscle mass in patients with MHD. The phase angle is estimated based on the ratio of reactance (Xc) to resistance (R) and the formula is below: Pha (°) = arctangent (Xc / R) × (180° / π) [25] .…”

Predictors factors of COVID-19-associated mortality in dialysis patients: Importance of nutritional status

“…There are diverse scores and tools to assess nutritional status, although there are no current strong recommendations. Besides clinical scales, we usually employ bioelectrical impedance analysis (BIA), a rapid, fairly cheap and non-invasive method, whose evaluation consists of a body passage of an electric current, wich gives us information about body composition and nutritional status [14][15][16][17]. By using BIA it is possible to obtain the phase angle value (PhA), which is the resistance/ reactance ratio of body tissues.…”

“…The higher the value, better is the nutritional status. Hence, some studies demonstrated that PhA can be used as an outcome indicator, and it is associated to mortality in dialysis patients [14,[16][17][18].…”

“…There is a high prevalence of protein-energy wasting, and malnutrion in individuals under dialysis treatment, which compromisse outcomes and demands a constant and painstaking evaluation and management of nutritional status of this population [11][12][13][14][15].…”