Clinical Significance of Phase Angle for Assessing Quality of Life and Prognosis in Hemodialysis Patients.

Higher phase angle was significantly associated with favorable nutritional and laboratory parameters in hemodialysis patients.

• Study enrolled 319 HD patients in a multicenter cross-sectional design
• Higher PA correlated with higher hemoglobin, albumin, creatinine, and GNRI
• Higher PA correlated with lower NT-proBNP
• Patients were stratified into sex-specific PA quartiles for comparison

Phase angle correlated positively with muscle mass and intracellular water, and inversely with the ECW/ICW ratio.

• Body composition measures were compared across sex-specific PA quartile groups
• Higher PA was associated with greater intracellular water content
• Higher PA was associated with a lower extracellular to intracellular water ratio (ECW/ICW), indicating better cellular hydration status
• These associations reflect the relationship between PA and cellular integrity

Phase angle was independently associated with several physical QOL domains after multivariable adjustment.

• Health-related QOL was assessed using the SF-36 and KDQOL-SF™
• Multivariable linear regression models were used to test associations between PA and QOL
• PA remained independently associated with physical functioning, role-physical, and general health domains
• Associations persisted after adjustment for dialysis adequacy (Kt/V) and inflammation (CRP)

Kaplan-Meier analysis demonstrated lower survival in the lowest PA quartile among hemodialysis patients.

• Survival was evaluated using Kaplan-Meier analysis with Bonferroni-adjusted pairwise comparisons
• The lowest sex-specific PA quartile group had significantly worse survival compared to higher quartile groups
• ROC analysis identified sex-specific cutoff values for predicting mortality
• The mortality cutoff was 4.0° for females and 4.8° for males

Evidence for associations between phase angle, QOL, and prognosis in Japanese hemodialysis populations was previously limited prior to this multicenter confirmatory study.

• The study was designed as a multicenter confirmatory study to extend prior findings to a Japanese population
• 319 HD patients were included across multiple centers
• The study used a cross-sectional design for QOL analyses and survival analysis for prognostic outcomes
• The study aimed to confirm associations previously reported in other populations