Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients
Protein-energy wasting (PEW) is a devastating metabolic derangement that leads to increased morbidity and mortality in hemodialysis (HD) patients. This study aimed to determine the diagnostic test accuracy of bioelectrical impedance analysis derived-phase angle (PhA) in detecting PEW among HD patien...
| Main Authors: | , , , , , , |
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| Format: | Article |
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Multidisciplinary Digital Publishing Institute
2021
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| Online Access: | http://psasir.upm.edu.my/id/eprint/96225/ |
| _version_ | 1848862318487666688 |
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| author | Lim, Cordelia Kheng May Lim, Jun Hao Ibrahim, Imliya Chan, Yoke Mun Zakaria, Nor Fadhlina Yahya, Rosnawati Mat Daud, Zulfitri 'Azuan |
| author_facet | Lim, Cordelia Kheng May Lim, Jun Hao Ibrahim, Imliya Chan, Yoke Mun Zakaria, Nor Fadhlina Yahya, Rosnawati Mat Daud, Zulfitri 'Azuan |
| author_sort | Lim, Cordelia Kheng May |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Protein-energy wasting (PEW) is a devastating metabolic derangement that leads to increased morbidity and mortality in hemodialysis (HD) patients. This study aimed to determine the diagnostic test accuracy of bioelectrical impedance analysis derived-phase angle (PhA) in detecting PEW among HD patients. This was a multi-centre, cross-sectional study conducted amongst 152 multi-ethnic HD patients in Klang Valley, Malaysia. PEW was assessed using the International Society of Renal Nutrition and Metabolism criteria as the reference method. PhA was measured using a multi-frequency bioelectrical impedance spectroscopy at 50 kHz. Multiple and logistic regressions were used to determine factors associated with PhA and PEW diagnosis, respectively. A receiver operating characteristics curve analysis was used to establish the gender-specific PhA cut-offs to detect PEW. PEW existed in 21.1% of the HD patients. PhA was found as an independent predictor of PEW (adjOR = 0.308, p = 0.001), with acceptable to excellent discriminative performance (adjAUCmale = 0.809; adjAUCfemale = 0.719). Male patients had higher PhA cut-off compared to female patients (4.26° vs. 3.30°). We concluded that PhA is a valid and pragmatic biomarker to detect PEW in multi-ethnic Malaysian HD patients and a gender-specific cut-off is necessary, attributed to the gender differences in body composition. |
| first_indexed | 2025-11-15T13:15:07Z |
| format | Article |
| id | upm-96225 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-15T13:15:07Z |
| publishDate | 2021 |
| publisher | Multidisciplinary Digital Publishing Institute |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-962252023-02-13T07:47:36Z http://psasir.upm.edu.my/id/eprint/96225/ Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients Lim, Cordelia Kheng May Lim, Jun Hao Ibrahim, Imliya Chan, Yoke Mun Zakaria, Nor Fadhlina Yahya, Rosnawati Mat Daud, Zulfitri 'Azuan Protein-energy wasting (PEW) is a devastating metabolic derangement that leads to increased morbidity and mortality in hemodialysis (HD) patients. This study aimed to determine the diagnostic test accuracy of bioelectrical impedance analysis derived-phase angle (PhA) in detecting PEW among HD patients. This was a multi-centre, cross-sectional study conducted amongst 152 multi-ethnic HD patients in Klang Valley, Malaysia. PEW was assessed using the International Society of Renal Nutrition and Metabolism criteria as the reference method. PhA was measured using a multi-frequency bioelectrical impedance spectroscopy at 50 kHz. Multiple and logistic regressions were used to determine factors associated with PhA and PEW diagnosis, respectively. A receiver operating characteristics curve analysis was used to establish the gender-specific PhA cut-offs to detect PEW. PEW existed in 21.1% of the HD patients. PhA was found as an independent predictor of PEW (adjOR = 0.308, p = 0.001), with acceptable to excellent discriminative performance (adjAUCmale = 0.809; adjAUCfemale = 0.719). Male patients had higher PhA cut-off compared to female patients (4.26° vs. 3.30°). We concluded that PhA is a valid and pragmatic biomarker to detect PEW in multi-ethnic Malaysian HD patients and a gender-specific cut-off is necessary, attributed to the gender differences in body composition. Multidisciplinary Digital Publishing Institute 2021 Article PeerReviewed Lim, Cordelia Kheng May and Lim, Jun Hao and Ibrahim, Imliya and Chan, Yoke Mun and Zakaria, Nor Fadhlina and Yahya, Rosnawati and Mat Daud, Zulfitri 'Azuan (2021) Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients. Diagnostics, 11 (10). art. no. 1745. pp. 1-15. ISSN 2075-4418 https://www.mdpi.com/2075-4418/11/10/1745 10.3390/diagnostics11101745 |
| spellingShingle | Lim, Cordelia Kheng May Lim, Jun Hao Ibrahim, Imliya Chan, Yoke Mun Zakaria, Nor Fadhlina Yahya, Rosnawati Mat Daud, Zulfitri 'Azuan Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients |
| title | Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients |
| title_full | Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients |
| title_fullStr | Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients |
| title_full_unstemmed | Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients |
| title_short | Bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients |
| title_sort | bioelectrical impedance analysis derived-phase angle as a pragmatic tool to detect protein energy wasting among multi-ethnic hemodialysis patients |
| url | http://psasir.upm.edu.my/id/eprint/96225/ http://psasir.upm.edu.my/id/eprint/96225/ http://psasir.upm.edu.my/id/eprint/96225/ |