Bioelectrical impedance analysis-derived phase angle as a determinant of protein-energy wasting and frailty in maintenan
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RESEARCH ARTICLE
Open Access
Bioelectrical impedance analysis-derived phase angle as a determinant of proteinenergy wasting and frailty in maintenance hemodialysis patients: retrospective cohort study Masakazu Saitoh1,2,3* , Masumi Ogawa3, Hisae Kondo3, Kiichi Suga3, Tetsuya Takahashi1, Haruki Itoh4 and Yoichiro Tabata3
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 (JCHS) 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. Keywords: Bioimpedance electrical analysis, Frailty, Hemodialysis, Phase angle, Protein energy wasting
* Correspondence: [email protected] 1 Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan 2 Department of Rehabilitation, Sakakibara Heart Institute, Tokyo, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creat
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