Chen Yi-Qin, Chen Hui-Fen, Han Yan, Shen Yu-Han, Zhang Yi-Dan, Fu Li-Zhe, Tang Fang, Liu Xu-Sheng, Wu Yi-Fan
The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Chronic Disease Management Outpatient Clinic, The Second Affiliated Hospital of Guangzhou, University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China.
Front Nutr. 2025 Jun 6;12:1580037. doi: 10.3389/fnut.2025.1580037. eCollection 2025.
Phase angle (PhA) obtained through bioimpedance analysis has been linked to mortality and malnutrition in dialysis patients. However, it remains unclear whether PhA is associated with renal prognosis in non-dialysis CKD patients.
Two thousand two hundred two CKD patients were enrolled in the SMP-CKD cohort, Guangdong Provincial Hospital of Traditional Chinese Medicine from July 1, 2015 to May 31, 2024. Participants undertook bioimpedance measures, and the correlation between PhA and renal endpoint was analyzed. Analytical approaches include Cox proportional hazards analysis and group-based trajectory modeling. Composite outcome is defined as the first occurrence of >30% decline or <5 mL/min/1.73min eGFR, doubled of SCr from the baseline, initiation of continuous dialysis therapy or receipt of a kidney transplant, or all-cause mortality.
During a mean follow-up of time 2.5 years, 570(25.9%) participants reached the composite endpoint. In the multivariable Cox regression model, subjects belonging to higher quartiles of phase angle presented with a decreased risk of poor prognosis, showing 29 and 38% risk reductions in Q3 (aHR 0.71, 95%CI 0.55-0.93) and Q4 (aHR 0.62, 0.45-0.85) versus Q1 (both < 0.05). When modeled in 2 groups according to the turning point of 5.0°, the adjusted hazard ratios (aHRs; 95% confidence intervals [CIs]) for broad-PhA group was 0.77(0.63, 0.95) compared with narrow-PhA group. The group-based trajectory modelling (GBTM) identified 4 trajectories, and the beneficial association remained consistent, with aHR (95% CIs) for group 2, group 3, group 4 were 0.69 (0.50-0.95), 0.59 (0.39-0.90), 0.47 (0.24-0.93), respectively, compared with group 1.
Phase angle could be useful in determining nutritional status of CKD patients, lower phase angle is an independent risk factor for poor prognosis in CKD patients.
通过生物电阻抗分析获得的相位角（PhA）与透析患者的死亡率和营养不良有关。然而，尚不清楚PhA是否与非透析慢性肾脏病（CKD）患者的肾脏预后相关。
2015年7月1日至2024年5月31日期间，2202例CKD患者纳入广东省中医院SMP-CKD队列。参与者进行了生物电阻抗测量，并分析了PhA与肾脏终点之间的相关性。分析方法包括Cox比例风险分析和基于组的轨迹建模。复合结局定义为首次出现估计肾小球滤过率（eGFR）下降>30%或<5ml/min/1.73m²、血清肌酐（SCr）较基线翻倍、开始持续透析治疗或接受肾移植，或全因死亡。
在平均2.5年的随访期间，570例（25.9%）参与者达到复合终点。在多变量Cox回归模型中，相位角处于较高四分位数的受试者预后不良风险降低，与第一四分位数相比，第三四分位数（风险比[aHR]0.71，95%置信区间[CI]0.55-0.93）和第四四分位数（aHR 0.62，0.45-0.85）的风险分别降低29%和38%（均P<0.05）。根据5.0°的转折点分为两组进行建模时，宽相位角组的调整后风险比（aHRs；95%置信区间[CIs]）为0.77（0.63，0.95），而窄相位角组为0.77（0.63，0.95）。基于组的轨迹建模（GBTM）确定了4条轨迹，有益关联仍然一致，与第1组相比，第2组、第3组、第4组的aHR（95% CIs）分别为0.69（0.50-0.95）、0.59（0.39-0.90）、0.47（0.24-0.93）。
相位角有助于确定CKD患者的营养状况，较低的相位角是CKD患者预后不良的独立危险因素。
