Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, 518000, Guangdong, China.
Int Urol Nephrol. 2024 Feb;56(2):731-737. doi: 10.1007/s11255-023-03708-9. Epub 2023 Aug 5.
The objective of this study was to investigate the ability of phase angle and body composition to identify risk factors for mortality among patients receiving maintenance hemodialysis (MHD) treatment.
In this retrospective study, we examined the causes of death in 43 MHD patients who were treated at our hemodialysis center between January 2016 and December 2021 and compared the patients to 71 patients who survived during the same period. Body composition was measured using direct segmental multi-frequency bioelectrical impedance to obtain phase angle, fat-free mass (FFM), extracellular water/total body water (ECW/TBW), and waist circumference (WC). Laboratory data were also collected. Phase angle cut-off value-associated variables were identified using ROC analysis. The ability of body composition variables to identify risk factors for death in MHD patients was evaluated.
We found that cardiovascular disease was the most common cause of death among MHD patients. ROC curve analysis revealed that the optimal cut-off value for phase angle as a predictor of death risk in MHD patients was 4.50°. Additionally, lower phase angle, increased age, longer dialysis vintage, lower KT/V, and hypoproteinemia were identified as significant risk factors for death in MHD patients.
In conclusion, our findings suggest that cardiovascular disease is the leading cause of death among MHD patients and that lower phase angle, increased age, longer dialysis duration, and hypoproteinemia can be used to predict the risk of mortality in this patient population. The underlying mechanism by which lower phase angle can be used to predict the prognosis of MHD patients warrants further investigation.
本研究旨在探讨相位角和身体成分在识别接受维持性血液透析（MHD）治疗的患者死亡风险因素方面的能力。
在这项回顾性研究中，我们检查了在 2016 年 1 月至 2021 年 12 月期间在我们血液透析中心接受治疗的 43 名 MHD 患者的死亡原因，并将这些患者与同期存活的 71 名患者进行了比较。使用直接节段多频生物电阻抗法测量身体成分，以获得相位角、去脂体重（FFM）、细胞外液/总体水（ECW/TBW）和腰围（WC）。还收集了实验室数据。使用 ROC 分析确定与相位角截断值相关的变量。评估身体成分变量识别 MHD 患者死亡风险因素的能力。
我们发现心血管疾病是 MHD 患者死亡的最常见原因。ROC 曲线分析显示，相位角作为预测 MHD 患者死亡风险的最佳截断值为 4.50°。此外，较低的相位角、较高的年龄、较长的透析龄、较低的 KT/V 和低蛋白血症被确定为 MHD 患者死亡的显著危险因素。
总之，我们的研究结果表明，心血管疾病是 MHD 患者死亡的主要原因，较低的相位角、较高的年龄、较长的透析时间和低蛋白血症可用于预测该患者人群的死亡风险。较低的相位角用于预测 MHD 患者预后的潜在机制需要进一步研究。
