The Correlation of Nutritional Status and Phase Angle in Hemodialysis Patient

Authors

  • Okky Hartanto Department of Clinical Nutrition Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia
  • Niken Puruhita Department of Clinical Nutrition Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia
  • Khairuddin Khairuddin Department of Clinical Nutrition Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia
  • Siti Fatimah Muis Department of Clinical Nutrition Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia
  • Febe Christianto Department of Clinical Nutrition Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v10i1.795

Keywords:

CKD, Hemodialysis, Nutritional Status, 7-point SGA, Phase Angle

Abstract

BACKGROUND: Nutritional problem are often experienced by patients with chronic kidney disease (CKD) undergoing regular hemodialysis. There are various tools that can be used to evaluate nutritional status, such as the 7-point Subjective Global Assessment (SGA), nevertheless, malnutrition in these patients is still underdiagnosed and resulting in worse clinical outcomes. Phase Angle (PhA) as measured by multi-frequency Bioelectrical Impedance Analysis (BIA) may detect nutritional problem in early stage in order to start nutrition therapy early.

OBJECTIVE: To analyze correlation between nutritional status and PhA in CKD patients with regular hemodialysis.

METHODS: The subject of this study were 39 CKD patients undergoing regular hemodialysis who met the inclusion and exclusion criteria. Nutritional status was evaluated by 7-point SGA, while PhA was measured by multi-frequency BIA. Correlation between variables analyzed by Spearman correlation test.

RESULT: Positive correlation was observed between nutritional status and PhA (r = 0,64; p < 0,001). There was a negative correlation between PhA and number of comorbids (r = -0,381, p = 0,017). PhA was not correlated with sex and hemodialysis duration.

CONCLUSION: There is positive correlation between nutritional status measured by 7-point SGA and PhA in CKD patients with regular hemodialysis.

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References

  1. Carrero JJ, Thomas F, Nagy K, Arogundade F, Avesani CM, Chan M, et al. Global Prevalence of Protein-Energy Wasting in Kidney Disease: A Meta-analysis of Contemporary Observational Studies From the International Society of Renal Nutrition and Metabolism. Journal of Renal Nutrition. 2018 Nov 1;28(6):380–92.
  2. Ikizler TA, Cuppari L. The 2020 Updated KDOQI Clinical Practice Guidelines for Nutrition in Chronic Kidney Disease. BPU. 2021;50(4–5):667–71.
  3. Steiber A, Leon JB, Secker D, McCarthy M, McCann L, Serra M, et al. Multicenter Study of the Validity and Reliability of Subjective Global Assessment in the Hemodialysis Population. Journal of Renal Nutrition. 2007 Sep 1;17(5):336–42.
  4. Lim SL, Lin XH, Daniels L. Seven-Point Subjective Global Assessment Is More Time Sensitive Than Conventional Subjective Global Assessment in Detecting Nutrition Changes. Journal of Parenteral and Enteral Nutrition. 2016;40(7):966–72.
  5. Rinaldi S, Gilliland J, O’Connor C, Chesworth B, Madill J. Is phase angle an appropriate indicator of malnutrition in different disease states? A systematic review. Clinical Nutrition ESPEN. 2019 Feb 1;29:1–14.
  6. Genton L, Herrmann FrançoisR, Spörri A, Graf CE. Association of mortality and phase angle measured by different bioelectrical impedance analysis (BIA) devices. Clinical Nutrition. 2018 Jun;37(3):1066–9.
  7. Marra M, Sammarco R, De Lorenzo A, Iellamo F, Siervo M, Pietrobelli A, et al. Assessment of Body Composition in Health and Disease Using Bioelectrical Impedance Analysis (BIA) and Dual Energy X-Ray Absorptiometry (DXA): A Critical Overview. Contrast Media &#x26; Molecular Imaging. 2019 May 29;2019:e3548284.
  8. Garlini LM, Alves FD, Ceretta LB, Perry IS, Souza GC, Clausell NO. Phase angle and mortality: a systematic review. Eur J Clin Nutr. 2019 Apr;73(4):495–508.
  9. Beberashvili I, Azar A, Sinuani I, Shapiro G, Feldman L, Stav K, et al. Bioimpedance phase angle predicts muscle function, quality of life and clinical outcome in maintenance hemodialysis patients. Eur J Clin Nutr. 2014 Jun;68(6):683–9.
  10. Janardhan V, Soundararajan P, Rani NV, Kannan G, Thennarasu P, Chacko RA, et al. Prediction of Malnutrition Using Modified Subjective Global Assessment-dialysis Malnutrition Score in Patients on Hemodialysis. Indian J Pharm Sci. 2011;73(1):38–45.
  11. Ramayana I, Nasution AT, Lubis AR. Relationship Between 7-Point Subjective Global Assessment With Phase Angle And Quality Of Life In Chronic Kidney Disease Patients With Regular Hemodialysis. 2018;9(11):18.
  12. Tan R shao, Liang D hua, Liu Y, Zhong X shi, Zhang D sheng, Ma J. Bioelectrical Impedance Analysis–Derived Phase Angle Predicts Protein–Energy Wasting in Maintenance Hemodialysis Patients. Journal of Renal Nutrition. 2019 Jul 1;29(4):295–301.
  13. Presiden Republik Indonesia. UU No. 13 Tahun 1998 tentang Kesejahteran Lanjut Usia. Republik Indonesia. 1998.
  14. Menteri Kesehatan Republik Indonesia. PMK No. 25 tahun 2016 tentang Rencana Aksi Nasional Kesehatan Lanjut Usia Tahun 2016-2019. 2016.
  15. Lim JU, Lee JH, Kim JS, Hwang YI, Kim TH, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis. 2017 Aug 21;12:2465–75.
  16. Lukaski HC, Kyle UG, Kondrup J. Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: phase angle and impedance ratio. Current Opinion in Clinical Nutrition and Metabolic Care. 2017 Sep;20(5):330–9.
  17. Gonzalez MC, Barbosa-Silva TG, Bielemann RM, Gallagher D, Heymsfield SB. Phase angle and its determinants in healthy subjects: influence of body composition. The American Journal of Clinical Nutrition. 2016 Mar 1;103(3):712–6.
  18. Shin J ho, Kim CR, Park KH, Hwang JH, Kim SH. Predicting clinical outcomes using phase angle as assessed by bioelectrical impedance analysis in maintenance hemodialysis patients. Nutrition. 2017 Sep 1;41:7–13.
  19. Han BG, Lee JY, Kim JS, Yang JW. Clinical Significance of Phase Angle in Non-Dialysis CKD Stage 5 and Peritoneal Dialysis Patients. Nutrients. 2018 Sep;10(9):1331.
  20. Chen CT, Lin SH, Chen JS, Hsu YJ. Muscle Wasting in Hemodialysis Patients: New Therapeutic Strategies for Resolving an Old Problem. The Scientific World Journal. 2013 Dec 5;2013:e643954.
  21. Rachmaningrum G. Faktor-faktor yang Berhubungan dengan Keterlambatan Rujukan Pasien Penyakit Ginjal Kronik di RSUPN Dr. Ciptomangunkusumo. [Jakarta]: Fakultas Kedokteran Universitas Indonesia; 2019.
  22. Al Salmi I, Larkina M, Wang M, Subramanian L, Morgenstern H, Jacobson SH, et al. Missed Hemodialysis Treatments: International Variation, Predictors, and Outcomes in the Dialysis Outcomes and Practice Patterns Study (DOPPS). American Journal of Kidney Diseases. 2018 Nov 1;72(5):634–43.

Additional Files

Published

2023-03-31

How to Cite

1.
Hartanto O, Puruhita N, Khairuddin K, Muis SF, Christianto F. The Correlation of Nutritional Status and Phase Angle in Hemodialysis Patient. Medica Hospitalia J. Clin. Med. [Internet]. 2023 Mar. 31 [cited 2024 May 3];10(1):76-82. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/795

Issue

Vol. 10 No. 1 (2023): Med Hosp; March 2023

Section

Original Article

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