Malnutrition Assessment in Hemodialysis Patients: Role of Bioelectrical Impedance Analysis Phase Angle

Rimševičius, Laurynas; Gincaite, Alvita; Vicka, Vaidas; Sukackienė, Diana; Pavinic, Jelena; Miglinas, Marius

doi:10.1053/j.jrn.2016.05.004

Cited by 23 publications

(18 citation statements)

References 30 publications

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“…Aside from the effectiveness as a prognostic indicator of survival, as previously reported, 16 our results support the predictive ability of phase angle for health adverse events among community-dwelling elderly. Largely, phase angle has been validated among patient populations, such as cancer and haemodialysis patients, as predictors of disease prognosis, 12 impaired quality of life, 13 malnutrition, 31 and increased mortality. 32 Findings of the present study suggested the usefulness of phase angle as a routine assessment in communitybased health screening and indicated simple and highly prognostic cut-off values for the detection of older individuals at high risk of disability in the near future.…”

Section: Discussionmentioning

confidence: 99%

Predictivity of bioimpedance phase angle for incident disability in older adults

Uemura

Doi

Tsutsumimoto

et al. 2019

J cachexia sarcopenia muscle

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Background Bioelectrical impedance analysis (BIA)‐derived phase angle is expected to be an efficient prognostic marker of health adverse events with aging as an alternative of muscle mass. We aimed to examine the predictive ability of phase angle for incident disability in community‐dwelling elderly and determine the optimal cut‐off values. Methods Community‐dwelling elderly aged ≥65 years (n = 4452; mean age = 71.8 ± 5.3 years, 48.3% women) without disability at baseline participated in this prospective cohort study. Phase angle and appendicular skeletal muscle mass (ASM) were examined using a multi‐frequency BIA at baseline. Other potential confounding factors (demographics, cognitive function, depressive symptoms, medications, and physical performance) were also assessed. Incident disability was monitored on the basis of long‐term care insurance certification. Results Over a follow‐up of 24 months, 4.0% (n = 174) experienced disability, with an overall incidence rate of 20.6 per 1000 person‐years. The Cox hazard regression analysis showed that phase angle, as a continuous variable, was independently associated with incident disability after adjusting the covariates [male: hazard ratios (HRs) = 0.61, 95% confidence interval (CI) = 0.37–0.98; female: HR = 0.58, 95% CI = 0.37–0.90], although body mass index adjusted ASM was not. Receiver operating characteristic analysis indicated moderate predictive abilities of phase angle for incident disability [male: area under the receiver operating characteristic curve (AUC) = 0.76, 95% CI = 0.70–0.83; female: AUC = 0.71, 95% CI = 0.65–0.76], while those of body mass index adjusted ASM were low (male: AUC = 0.59, 95% CI = 0.521–0.66; female: AUC = 0.58, 95% CI = 0.52–0.63). Multivariate Cox regression analysis showed that low phase angle categorized by cut‐off value (male, ≤4.95°; female, ≤4.35°) was independently related to increased risk of incident disability (HR = 1.95, 95% CI = 1.37–2.78). Conclusions Lower phase angle independently predicts the incident disability separately from known risk factors. BIA‐derived phase angle can be used as a valuable and simple prognostic tool to identify the elderly at risk of disability as targets of preventive treatment.

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Section: Discussionmentioning

confidence: 99%

Predictivity of bioimpedance phase angle for incident disability in older adults

Uemura

Doi

Tsutsumimoto

et al. 2019

J cachexia sarcopenia muscle

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“…In many diseases, the PhA is known to be linked to nutritional status and to predict morbidity and mortality for certain diseases [1][2][3]. The PhA can also reflect the nutritional status of patients with end stage renal disease (ESRD) undergoing maintenance hemodialysis or not on dialysis [5][6][7]. The PhA has been used to study other diseases, but few studies have been conducted exclusively on patients with DMCKD stage 5.…”

Section: Discussionmentioning

confidence: 99%

“…The phase angle (PhA) is known as an indicator of cell integrity and a predictor of body cell mass, and has been suggested to be a prognostic, health, functional, and nutritional indicator of several diseases [1][2][3][4]. Of course, studies on the PhA have also been published in the area of kidney disease [5][6][7]. The PhA is a strictly objective rather than subjective measure.…”

Section: Introductionmentioning

confidence: 99%

Decreased Bioimpedance Phase Angle in Patients with Diabetic Chronic Kidney Disease Stage 5

et al. 2019

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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.

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“…Oliveira et al2, al evaluar a 58 pacientes en hemodiálisis en un centro en el Nordeste del Brasil, con promedio de edad de 49,2±14,8 años, describieron valores medios de 6,2±1,3º AF. Rimsevicius et al 26 , relataron promedio de AF de 4,9±1,1º al analizar los datos de 99 pacientes en hemodiálisis con promedio de edad de 58,7±14,4 años. Esas posibles variaciones vienen siendo atribuidas a las diferencias poblacionales (edad, etnia, estado nutricional, condición clínica) y a los diferentes equipos de IBE utilizados 27 .…”

Section: Discussionunclassified

Asociación del ángulo de fase con parámetros de evaluación del estado nutricional en pacientes en hemodiálisis

Duarte

Pinho²,

Barboza

et al. 2019

Rev. chil. nutr.

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RESUMEN La desnutrición energético-proteica es altamente prevalente en pacientes en tratamiento con diálisis, siendo un importante marcador de riesgo para morbimortalidad. Entre los diversos parámetros disponibles para evaluación de la condición nutricional, la medida del Ángulo de Fase (AF) se ha señalado como marcador útil para evaluar a pacientes en hemodiálisis (HD). Objetivo: Evaluar la asociación del AF con parámetros de evaluación del estado nutricional en pacientes en HD. Métodos: Se realizó un estudio transversal entre febrero y julio de 2016 en dos unidades de hemodiálisis, de Recife, Nordeste brasileño. Resultados: Se evaluó a 101 pacientes, con edades de 51,7±16,8 años e IMC de 24,3±4,5 kg/m². El promedio del AF fue 5,6±1,7° y se correlacionó inversamente con la edad (r=-0,222; p= 0,024) y con el % grasa (r=-0,219; p= 0,026) y directamente con la altura (r= 0,286; p= 0,003), con el índice de masa muscular esquelética (r= 0,269; p= 0,006), con la fuerza de agarre palmar (r= 0,627;p <0,001), velocidad de marcha (r= 0,263; p= 0,008), masa libre de grasa (r= 0,303; p= 0,002) y creatininemia (r= 0,278; p= 0,004). Conclusiones: El AF presentó asociación con algunos parámetros de evaluación nutricional, que puede ser una medida útil adicional para reflejar la condición nutricional y evaluar la sarcopenia en pacientes en HD.

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Malnutrition Assessment in Hemodialysis Patients: Role of Bioelectrical Impedance Analysis Phase Angle

Cited by 23 publications

References 30 publications

Predictivity of bioimpedance phase angle for incident disability in older adults

Predictivity of bioimpedance phase angle for incident disability in older adults

Decreased Bioimpedance Phase Angle in Patients with Diabetic Chronic Kidney Disease Stage 5

Asociación del ángulo de fase con parámetros de evaluación del estado nutricional en pacientes en hemodiálisis

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