ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1580037
This article is part of the Research TopicBioimpedance Analysis: Lifelong Health, Disease, and Sport ApplicationsView all 8 articles
Lower phase angle as a marker for poor prognosis in patients with chronic kidney disease: A cohort study
Provisionally accepted
Yi-Qin Chen1
Hui-Fen Chen1Yan Han1Yu -Han Shen1Yi-Dan Zhang1Li-Zhe Fu2Fang Tang2
Xusheng Liu1,2,3
Yifan Wu1,2*- 1Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China
- 2The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- 3Chinese Medicine Guangdong Laboratory, Guangdong Hengqin, China
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Objective: Phase angle (PhA) obtained through bioimpedance analysis has been linked to mortality and malnutrition in dialysis patients. However, it remains unclear whether PhA is associated with renal prognosis in non-dialysis CKD patients.: 2202 CKD patients were enrolled in the SMP-CKD cohort, Guangdong Provincial Hospital of Traditional Chinese Medicine from July 1, 2015 to May 31, 2024. Participants undertook bioimpedance measures, and the correlation between PhA and renal endpoint was analyzed. Analytical approaches include Cox proportional hazards analysis and group-based trajectory modeling. Composite outcome is defined as the first occurrence of ＞ 30% decline or ＜5ml/min/1.73m²in eGFR, doubled of SCr from the baseline, initiation of continuous dialysis therapy or receipt of a kidney transplant, or all-cause mortality.Results: During a mean follow-up of time 2.5 years, 570(25.9%) participants reached the composite endpoint. In the multivariable Cox regression model, subjects belonging to higher quartiles of phase angle presented with a decreased risk of poor prognosis, showing 29% and 38% risk reductions in Q3 (aHR 0.71, 95%CI 0.55-0.93) and Q4 (aHR 0.62, 0.45-0.85) versus Q1 (both P<0.05). When modeled in 2 groups according to the turning point of 5.0°, the adjusted hazard ratios (aHRs; 95% confidence intervals [CIs]) for broad-PhA group was 0.77(0.63, 0.95) compared with narrow-PhA group. The group-based trajectory modelling (GBTM) identified 4 trajectories, and the beneficial association remained consistent, with aHR (95% CIs) for group 2, group 3, group 4 were 0.69 (0.50-0.95) ,0.59 (0.39-0.90), 0.47 (0.24-0.93), respectively, compared with group 1.Conclusions: Phase angle could be useful in determining nutritional status of CKD patients, narrow phase angle is an independent risk factor for poor prognosis in CKD patients.
Keywords: Chronic Kidney Disease, phase angle, Bioimpedance, nutrition, cohort study
Received: 20 Feb 2025; Accepted: 21 May 2025.
Copyright: © 2025 Chen, Chen, Han, Shen, Zhang, Fu, Tang, Liu and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yifan Wu, The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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