AUTHOR=Sukackiene Diana , Rimsevicius Laurynas , Miglinas Marius 

TITLE=Standardized Phase Angle for Predicting Nutritional Status of Hemodialysis Patients in the Early Period After Deceased Donor Kidney Transplantation

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.803002

DOI=10.3389/fnut.2022.803002

ISSN=2296-861X

ABSTRACT=Background: This study was designed to verify whether early posttransplant standardized phase angle (SPhA) determines nutrition status of hemodialysis patients  in regard to different nutritional markers and predicts handgrip strength 6 months after kidney transplantation. 
Methods: 82 kidney transplant recipients on maintenance hemodialysis treatment entered the study. Nutritional status was evaluated before kidney transplantation, at the hospital discharge date and 6 months after. We  used bioelectrical impedance analysis, three different malnutrition screening tools, handgrip strength and anthropometric measurements. Demographic profiles and biochemical nutritional markers were collected. SPhA values adjusted for age and BMI were used in our study. 
Results: In the early posttransplant period, kidney transplant recipientslost muscle mass, gained fat mass and developed mostly negative SPhA accompanied by significantly lower albumin levels. The subjects with lower than median (< -1.46) SPhAdis (the SPhA (at discharge) adjusted for hospitalization time and the baseline SPhA) displayed lower values of albumin concentration (43.4 vs 45.1 g/l, p=0.010), hemoglobin (124 vs 133 g/l, p=0.016), GNRI (113 vs 118, p=0.041), and handgrip strength (30 vs 33 kg, p=0.043). These patients had higher ferritin concentrations (420 vs 258 mkmol/l, p=0.026), longer inpatient stays (32 vs 21 days, p<0.001), and higher MIS scores (3 vs 1, p=0.001). 
Conclusion: At the moment of hospital discharge, lower than the median SPhA is related to protein-energy wasting, represented as lower concentrations of nutrition biomarkers and an active inflammatory response. Higher SPhA before kidney transplantation predicts handgrip strength 6 months after kidney transplantation, specifically in women.