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Abstract: SA-PO348

Impact of Phase Angle and Sarcopenia Estimated by Bioimpedance Analysis on Clinical Prognosis in Patients Undergoing Hemodialysis: A Retrospective Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Lee, Tae won, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Korea (the Republic of)
  • Bae, Eunjin, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Korea (the Republic of)
  • Park, Dong Jun, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Korea (the Republic of)

Bioimpedance analysis (BIA) has been widely used in the evaluation of body composition in patients undergoing maintenance hemodialysis (MHD). We conducted this study to evaluate impact of PA and sarcopenia measured by BIA on clinical prognosis in these patients.


This longitudinal retrospective study enrolled patients who underwent hemodialysis between January 2016 and March 2019. The patients were stratified into higher (> 4°) and lower (≤ 4.0°) PA groups. Sarcopenia was defined when the appendicular skeletal muscle mass (ASM) was < 20 kg in men and < 15 kg in women.


Of the 191 patients, 63.4% were men. The mean age was 64.2 ± 12.4 years. The lower PA group was older, had a higher proportion of women, a lower BMI, lower albumin, cholesterol, uric acid, and phosphorus levels, and a higher incidence of history of coronary artery disease (CAD) than the higher PA group. Linear regression analysis revealed that PA was significantly associated with BMI (B=0.18, p=0.005), serum albumin (B=0.23, p=0.001), and creatinine levels (B=0.32, p<0.001). During a median follow-up of 16.7 months, 14.1% (n = 27) of patients experienced MACE and 11.0% (n = 21) died. Kaplan–Meier survival analysis showed that the higher PA group had significantly better survival, regardless of sarcopenia. Multivariate Cox analyses revealed that lower PA (0.51 [0.31-0.85], p=0.010), higher IDWG (1.06 [1.01-1.12], p=0.028) and C-reactive protein level (1.01 [1.01-1.02], p<0.001), and a history of CAD (3.02 [1.04-8.77], p=0.042) were significantly related to all-cause mortality after adjusting for other covariates.


PA measured by BIA was an independent factor in the prediction of mortality in MHD patients, regardless of sarcopenia. Intervention studies are needed to confirm if the improvement in PA is associated with better clinical outcome.