The use of bioelectrical impedance phase angle for predicting protein-energy wasting in hemodialysis patients / 中华临床营养杂志

ABSTRACT

Objective To evaluate the use of bioelectrical impedance phase angle (PhA) for predicting protein-energy wasting (PEW) in hemodialysis patients.Methods This cross-sectional study involved 144 patients who were on maintenance hemodialysis (MHD) in the blood purification centers of two tertiary hospitals in Guangzhou,where the body impedance analysis (BIA) was performed after the hemodialysis procedure and the prevalence of protein-energy wasting (PEW) was investigated by the 7-point subjective global assessment (SGA) among.Nutritional indices of the patients with PEW were compared with the well-nourished patients to identify independent variables that can predict PEW and determine the cut-off value of PhA as a predictor.Results The patients with PEW had significantly lower PhA values than the Non-PEWpatients (t =8.68,P=0.00).PhA was positively related with the nutritional indices reflecting function of body proteins or muscles,such as serum albumin (rs=0.25,P=0.00),prealbumin (rs=0.31,P=0.00),free fat mass index (rs=0.25,P=0.00),and mid-arm muscle circumference (rs =O.44,P =O.00).However,the correlations of PhA with fat mass (rs =0.04,P=0.66) and body fat percentage (rs =-0.04,P=0.66) were no statistical significance.Multivariate logistic regression analysis revealed that PhA (OR =4.48,P =0.00) and body mass index (OR =1.59,P =0.00) were independent predictors of PEW,but PhA was more potent than BMI.Receiver operating characteristic curve analysis suggested that the optimum PhA cut-off point for predicting PEW was 4.6.Conclusion PhA can be a useful independent predictor for PEW in hemodialysis patients and its cut-off value is 4.6.