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Abstract: SA-PO334

Impedance-Derived Phase Angle Is Associated With Muscle Strength and Physical Performance in Maintenance Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Li, Xin, Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
  • Yu, Chen, Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China

Phase angle (PhA) derived by bioelectrical impedance analysis (BIA) is an index of cellular health and cell membrane integrity. In maintenance hemodialysis (MHD) patients,PhA has been proposed as a predictor for protein-energy wasting (PEW). Declining in physical function is common in MHD patients, due to a variety of factors such as PEW and sarcopenia. It remains unclear if PhA is a valid marker to detect muscle function in MHD patients. The aim of this study was to identify the association between PhA and muscle function (muscle strength and physical performance) in MHD patients.


This was a multi-center, cross-sectional study included 864 (61% males; mean age 61.5±12.6 years) MHD patients from seven dialysis centers in Shanghai of China from 2020 to 2021. Muscle strength was measured by handgrip strength (HGS), and physical performance was measured via Short Physical Performance Battery (SPPB), 4-meter gait speed and Timed Up and Go Test (TUGT). Nutritional status was assessed by Malnutrition inflammation score (MIS). Body composition, including PhA at 50kHz, was measured by BIA. Linear regression models were performed to determine the associations between PhA and muscle function.


PhA (4.6±0.9) was negatively associated with age, MIS, extracellular water/total body water, visceral fat area and TUGT, and positively associated with hemoglobin, serum albumin, body mass index (BMI), skeletal muscle mass index, SPPB, 4-meter gait speed and HGS. PhA values of five body segments- right arm, left arm, trunk, right leg and left leg – also correlated well with muscle strength and physical performance. In the linear regression model further adjustments for age, gender, spKt/v, dialysis vintage, Charlson comorbidity index, MIS and BMI, PhA was positively correlated with SPPB (β=0.37, p-value <0.001), gait speed (β=0.32, p-value <0.001), HGS (β=0.32, p-value <0.001), and negatively associated with TUGT (β=-0.24, p-value <0.001).


Higher PhA was independently associated with better muscle strength and physical performance in MHD patients. Our study suggest that PhA can be used as a good marker to determine muscle function.