Association Between Phase Angle and Sarcopenia in Patients Undergoing Peritoneal Dialysis

Abstract

Introduction: There is limited data on the association between phase angle (PhA) and sarcopenia using both muscle strength and muscle mass in patients undergoing peritoneal dialysis (PD). We aimed to evaluate the association between PhA and sarcopenia in patients undergoing PD.Methods: We enrolled prevalent patients undergoing PD (n = 200). The patients were divided into tertiles based on their PhA level: low (n = 66; 1.9–4°), middle (n = 68; 4.1–4.9°), and high tertiles (n = 66; 5–8°). PhA was measured by a bioimpedance analysis. Handgrip strength (HGS) was measured in all the patients. Body compositions were measured by dual energy x-ray absorptiometry (DXA).Results: Handgrip strength (HGS) and/or lean mass indices showed poorer trends in the low tertile than in the other tertiles. PhA was positively associated with HGS and/or muscle mass index. Multivariate analyses showed that the patients in the low tertile had an odds ratio of 9.8 (p = 0.001) and 52.79 (p < 0.001) for developing sarcopenia compared with those in the middle and high tertiles, respectively. Subgroup analyses using these variables yielded results similar to those from the total cohort.Conclusion: This study demonstrated that PhA is independently associated with muscle mass, strength, and sarcopenia in patients undergoing PD. This result suggests that PhA can be used as a valuable and simple predictor for identifying patients undergoing PD who are at risk of sarcopenia.

Prevalence of Sarcopenia and Its Impact on Cardiovascular Events and Mortality among Dialysis Patients: A Systematic Review and Meta-Analysis

“…The studies were published between 2014 and 2022 and varied in sample size (33 to 645 patients). Among the included studies, twenty-one studies were conducted in Asian countries (China, Iran, Japan, Korea, Taiwan, Thailand, and Turkey) [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ], nine in European countries (France, Sweden, Spain, and United Kingdom) [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ], eight in South American countries (Brazil and Argentina) [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ], two in the USA [ 57 , 58 ], and the remaining one in Australia [ 59 ]. These studies yielded a total sample of five continents (Asia: 45.6%, Europe: 25.9%, North America: 14.3%, South America: 13.7%, and Australia: 0.5%).…”

Clinical Significance of Volume Status in Body Composition and Physical Performance Measurements in Hemodialysis Patients

“…Another important result in this study is the inverse association between the phase angle and volume status. Previous studies have shown an association between phase angle and prognosis, including nutritional status and mortality in dialysis patients ( 28 , 29 ). The phase angle is originally associated with cellularity and water content to cell mass, and a high phase angle reveals high cellularity and low extracellular water to intracellular water ratio ( 30 ).…”

The phase angle is associated with upper arm muscle circumference but not with sarcopenia in continuous ambulatory peritoneal dialysis patients

“…Han B et al[20] enrolled 80 patients undergoing PD showed that PhA correlated to serum albumin and lean tissue index (LTI) from bioimpedance. Recently, research including 200 patients with PD [21] demonstrated that PhA is independently associated with muscle mass, strength, and sarcopenia, but they used DXA to measure body composition. Whereas, in 2020, Pessoa et al illustrated that PhA had no association with sarcopenia, SMI, HGS, and walk speed in the old women[22].…”

“…Kosoku et al demonstrated a value of≤4.46 in kidney transplant patients, with a sensitivity of 74% and specificity of 70%[30]. Recently, a study about peritoneal dialysis without peritoneal dialysis fluid showed the cut-off value was≤4.4°(sensitivity 81.3%, specificity 59.6%)[21]. This may be since the total average age of our central dialysis patients(51.3±12.43 year) are lower than that of the patients included in the study (55.5±12.2 year).…”