Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease

David Seres; Clare Mckeaveney; Gary Adamson; Andrew Davenport; Ken Farrington; Denis Fouque; Kamyar Kalanter-Zadeh; John Mallett; Peter Maxwell; Robert Mullan; Helen Nobel; Donal O’Donoghue; Sam Porter; Joanne Shields; Adrian Slee; Miles Witham; Joanne Reid

doi:10.1093/cdn/nzaa055_029

Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease

David Seres, Clare Mckeaveney, Gary Adamson, Andrew Davenport, Ken Farrington, Denis Fouque, Kamyar Kalanter-Zadeh, John Mallett, Peter Maxwell, Robert Mullan, Helen Nobel, Donal O’Donoghue, Sam Porter, Joanne Shields, Adrian Slee, Miles Witham, Joanne Reid

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Abstract

Objectives This cross-sectional analysis sought to identify cachexia and assess survival using phase angle (PA) in patients with end-stage renal disease (ESRD) receiving haemodialysis. Methods Patients receiving haemodialysis (n = 87, mean age 65.9 +/– 13.0) completed a Phase Angle (PA; 50 khz) measurement using bioelectrical impedance analysis. Cachexia variables were recorded according to Evans et al. definition (2008) including nutritional and functional measures (weight, Body Mass Index (BMI), Hand Grip Strength (HGS), Lean Tissue Mass (LTM), C-Reative Protein (CRP), serum albumin, haemoglobin, appetite (Functional Assessment of Anorexia/Cachexia Treatment (FAACT)) and fatigue (Functional Assessment of Chronic Illness Therapy (FACIT)). Survival was assessed at 12 months. Mann Whitney-U and Spearman correlation coefficient were conducted. Results The majority of patients completed follow up (n = 76). Eleven patients had died. Mean PA was not statistically different between those identified as cachectic and non-cachectic according to Evans et al. (2008) definition or between those patients that survived and died. However, patients that survived had better mean scores of weight, BMI, HGS, CRP, serum albumin and fatigue (FACIT). In addition, LTM scores were significantly better in patients that survived (P < .01). Appetite scores were also significantly better in patients that survived (P < .01) and those without cachexia (P = .01). Conclusions This study was part of a larger effort to clarity a phenotype of cachexia in ESRD. Unlike previous research, this study did not find PA useful in identifying patients at a higher risk of cachexia or death. However overall these patients had a very low mean PA. FAACT did discriminate between groups indicating self-reporting measurement tools of nutritional status were useful in identifying patients at a higher risk of cachexia and death. A larger sample and longer follow up is required to balance the limitations of this small study. Timing the administration of PA also requires consideration in future studies. Funding Sources Public Health Agency; Northern Ireland Kidney Research Fund.

Original language	English
Article number	nzaa055_029
Pages (from-to)	1144
Number of pages	1
Journal	Current Developments in Nutrition
Volume	4
Issue number	Supplement 2
Early online date	10 Feb 2023
DOIs	https://doi.org/10.1093/cdn/nzaa055_029
Publication status	E-pub ahead of print - 10 Feb 2023

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© 2020 American Society for Nutrition. Published by Elsevier Inc. This is an Open access article under the CC-BY-NC-ND license. https://creativecommons.org/licenses/by-nc-nd/4.0/
Final published version, 59.4 KBLicence: CC BY-NC-ND

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Seres, D., Mckeaveney, C., Adamson, G., Davenport, A., Farrington, K., Fouque, D., Kalanter-Zadeh, K., Mallett, J., Maxwell, P., Mullan, R., Nobel, H., O’Donoghue, D., Porter, S., Shields, J., Slee, A., Witham, M., & Reid, J. (2023). Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease. Current Developments in Nutrition, 4(Supplement 2), 1144. Article nzaa055_029. Advance online publication. https://doi.org/10.1093/cdn/nzaa055_029

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title = "Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease",

abstract = "Objectives This cross-sectional analysis sought to identify cachexia and assess survival using phase angle (PA) in patients with end-stage renal disease (ESRD) receiving haemodialysis. Methods Patients receiving haemodialysis (n = 87, mean age 65.9 +/– 13.0) completed a Phase Angle (PA; 50 khz) measurement using bioelectrical impedance analysis. Cachexia variables were recorded according to Evans et al. definition (2008) including nutritional and functional measures (weight, Body Mass Index (BMI), Hand Grip Strength (HGS), Lean Tissue Mass (LTM), C-Reative Protein (CRP), serum albumin, haemoglobin, appetite (Functional Assessment of Anorexia/Cachexia Treatment (FAACT)) and fatigue (Functional Assessment of Chronic Illness Therapy (FACIT)). Survival was assessed at 12 months. Mann Whitney-U and Spearman correlation coefficient were conducted. Results The majority of patients completed follow up (n = 76). Eleven patients had died. Mean PA was not statistically different between those identified as cachectic and non-cachectic according to Evans et al. (2008) definition or between those patients that survived and died. However, patients that survived had better mean scores of weight, BMI, HGS, CRP, serum albumin and fatigue (FACIT). In addition, LTM scores were significantly better in patients that survived (P < .01). Appetite scores were also significantly better in patients that survived (P < .01) and those without cachexia (P = .01). Conclusions This study was part of a larger effort to clarity a phenotype of cachexia in ESRD. Unlike previous research, this study did not find PA useful in identifying patients at a higher risk of cachexia or death. However overall these patients had a very low mean PA. FAACT did discriminate between groups indicating self-reporting measurement tools of nutritional status were useful in identifying patients at a higher risk of cachexia and death. A larger sample and longer follow up is required to balance the limitations of this small study. Timing the administration of PA also requires consideration in future studies. Funding Sources Public Health Agency; Northern Ireland Kidney Research Fund.",

author = "David Seres and Clare Mckeaveney and Gary Adamson and Andrew Davenport and Ken Farrington and Denis Fouque and Kamyar Kalanter-Zadeh and John Mallett and Peter Maxwell and Robert Mullan and Helen Nobel and Donal O{\textquoteright}Donoghue and Sam Porter and Joanne Shields and Adrian Slee and Miles Witham and Joanne Reid",

note = "{\textcopyright} 2020 American Society for Nutrition. Published by Elsevier Inc. This is an Open access article under the CC-BY-NC-ND license. https://creativecommons.org/licenses/by-nc-nd/4.0/",

year = "2023",

month = feb,

day = "10",

doi = "10.1093/cdn/nzaa055_029",

language = "English",

volume = "4",

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Seres, D, Mckeaveney, C, Adamson, G, Davenport, A, Farrington, K, Fouque, D, Kalanter-Zadeh, K, Mallett, J, Maxwell, P, Mullan, R, Nobel, H, O’Donoghue, D, Porter, S, Shields, J, Slee, A, Witham, M & Reid, J 2023, 'Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease', Current Developments in Nutrition, vol. 4, no. Supplement 2, nzaa055_029, pp. 1144. https://doi.org/10.1093/cdn/nzaa055_029

TY - JOUR

T1 - Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease

AU - Seres, David

AU - Mckeaveney, Clare

AU - Adamson, Gary

AU - Davenport, Andrew

AU - Farrington, Ken

AU - Fouque, Denis

AU - Kalanter-Zadeh, Kamyar

AU - Mallett, John

AU - Maxwell, Peter

AU - Mullan, Robert

AU - Nobel, Helen

AU - O’Donoghue, Donal

AU - Porter, Sam

AU - Shields, Joanne

AU - Slee, Adrian

AU - Witham, Miles

AU - Reid, Joanne

PY - 2023/2/10

Y1 - 2023/2/10

N2 - Objectives This cross-sectional analysis sought to identify cachexia and assess survival using phase angle (PA) in patients with end-stage renal disease (ESRD) receiving haemodialysis. Methods Patients receiving haemodialysis (n = 87, mean age 65.9 +/– 13.0) completed a Phase Angle (PA; 50 khz) measurement using bioelectrical impedance analysis. Cachexia variables were recorded according to Evans et al. definition (2008) including nutritional and functional measures (weight, Body Mass Index (BMI), Hand Grip Strength (HGS), Lean Tissue Mass (LTM), C-Reative Protein (CRP), serum albumin, haemoglobin, appetite (Functional Assessment of Anorexia/Cachexia Treatment (FAACT)) and fatigue (Functional Assessment of Chronic Illness Therapy (FACIT)). Survival was assessed at 12 months. Mann Whitney-U and Spearman correlation coefficient were conducted. Results The majority of patients completed follow up (n = 76). Eleven patients had died. Mean PA was not statistically different between those identified as cachectic and non-cachectic according to Evans et al. (2008) definition or between those patients that survived and died. However, patients that survived had better mean scores of weight, BMI, HGS, CRP, serum albumin and fatigue (FACIT). In addition, LTM scores were significantly better in patients that survived (P < .01). Appetite scores were also significantly better in patients that survived (P < .01) and those without cachexia (P = .01). Conclusions This study was part of a larger effort to clarity a phenotype of cachexia in ESRD. Unlike previous research, this study did not find PA useful in identifying patients at a higher risk of cachexia or death. However overall these patients had a very low mean PA. FAACT did discriminate between groups indicating self-reporting measurement tools of nutritional status were useful in identifying patients at a higher risk of cachexia and death. A larger sample and longer follow up is required to balance the limitations of this small study. Timing the administration of PA also requires consideration in future studies. Funding Sources Public Health Agency; Northern Ireland Kidney Research Fund.

AB - Objectives This cross-sectional analysis sought to identify cachexia and assess survival using phase angle (PA) in patients with end-stage renal disease (ESRD) receiving haemodialysis. Methods Patients receiving haemodialysis (n = 87, mean age 65.9 +/– 13.0) completed a Phase Angle (PA; 50 khz) measurement using bioelectrical impedance analysis. Cachexia variables were recorded according to Evans et al. definition (2008) including nutritional and functional measures (weight, Body Mass Index (BMI), Hand Grip Strength (HGS), Lean Tissue Mass (LTM), C-Reative Protein (CRP), serum albumin, haemoglobin, appetite (Functional Assessment of Anorexia/Cachexia Treatment (FAACT)) and fatigue (Functional Assessment of Chronic Illness Therapy (FACIT)). Survival was assessed at 12 months. Mann Whitney-U and Spearman correlation coefficient were conducted. Results The majority of patients completed follow up (n = 76). Eleven patients had died. Mean PA was not statistically different between those identified as cachectic and non-cachectic according to Evans et al. (2008) definition or between those patients that survived and died. However, patients that survived had better mean scores of weight, BMI, HGS, CRP, serum albumin and fatigue (FACIT). In addition, LTM scores were significantly better in patients that survived (P < .01). Appetite scores were also significantly better in patients that survived (P < .01) and those without cachexia (P = .01). Conclusions This study was part of a larger effort to clarity a phenotype of cachexia in ESRD. Unlike previous research, this study did not find PA useful in identifying patients at a higher risk of cachexia or death. However overall these patients had a very low mean PA. FAACT did discriminate between groups indicating self-reporting measurement tools of nutritional status were useful in identifying patients at a higher risk of cachexia and death. A larger sample and longer follow up is required to balance the limitations of this small study. Timing the administration of PA also requires consideration in future studies. Funding Sources Public Health Agency; Northern Ireland Kidney Research Fund.

U2 - 10.1093/cdn/nzaa055_029

DO - 10.1093/cdn/nzaa055_029

M3 - Article

SN - 2475-2991

VL - 4

SP - 1144

JO - Current Developments in Nutrition

JF - Current Developments in Nutrition

IS - Supplement 2

M1 - nzaa055_029

ER -

Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease

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