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Kidney Week

Abstract: FR-PO0529

Phase Angle as a Prognostic Marker for Mortality in Patients Undergoing Peritoneal Dialysis

Session Information

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Chingchana, Preerati, Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
  • Boongird, Sarinya, Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
  • Meenetkum, Sasiwimon, Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
  • Chuengsaman, Piyatida, Banphaeo-Charoenkrung Peritoneal Dialysis Center, Banphaeo Dialysis Group, Banphaeo Hospital, Bangkok, Thailand
  • Shantavasinkul, Prapimporn Chattranukulchai, Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Kitiyakara, Chagriya, Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
Background

Phase angle (PA), measured by bioelectrical impedance analysis (BIA), reflects cellular integrity and nutritional status. While PA is a known prognostic marker in chronic kidney disease, its value in peritoneal dialysis (PD) remains unclear. This study assessed associations between PA, mortality, sarcopenia components, and identified an optimal PA threshold for risk stratification.

Methods

This secondary analysis of the SARCO-CKD multicenter cohort included 356 adult PD patients recruited at two major hospitals in Bangkok, Thailand, from 2021 to 2024. Baseline PA was measured via multifrequency BIA. Sarcopenia and its components—muscle mass, handgrip strength, and gait speed—were assessed based on the 2019 Asian Working Group for Sarcopenia criteria. The primary outcome was all-cause mortality. Cox proportional hazards models assessed the association between PA and mortality, while logistic regression analyzed links between PA and sarcopenia components. ROC analysis determined the optimal PA cutoff for predicting mortality.

Results

Over a median follow-up of 29.6 months (IQR 11.3–31.9), 68 patients (19.1%) died. Mean age was 60.1±9.4 years; 43.8% were male. Higher PA was independently associated with lower mortality risk (adjusted HR 0.58; 95% CI, 0.42–0.80; P=0.001). A PA cutoff of 3.3° showed moderate predictive value (AUC 0.62; sensitivity 61.8%; specificity 65.6%), outperforming serum albumin (AUC 0.55) and age (AUC 0.58). Patients with PA ≥3.3° had significantly better survival (log-rank P<0.001). Additionally, higher PA was associated with preserved handgrip strength (adjusted OR 0.41; 95% CI, 0.32–0.62; P<0.001).

Conclusion

The threshold of 3.3° effectively stratifies mortality risk and correlates with handgrip strength in this cohort. These findings support PA as a clinical risk marker, with further studies needed to evaluate its role in guiding interventions.

Kaplan-Meier survival curves stratified by PA threshold

Digital Object Identifier (DOI)