Low Phase Angle Values Are Associated with Malnutrition according to the Global Leadership Initiative on Malnutrition Criteria in Kidney Transplant Candidates: Preliminary Assessment of Diagnostic Accuracy in the FRAILMar Study

• Published in: Nutrients 2023-02, Vol.15 (5), p.1084
• Main Authors: Muñoz-Redondo, Elena, Morgado-Pérez, Andrea, Pérez-Sáez, María-José, Faura, Anna, Sánchez-Rodríguez, Dolores, Tejero-Sánchez, Marta, Meza-Valderrama, Delky, Muns, María Dolors, Pascual, Julio, Marco, Ester
• Format: Article
• Language: English
• Subjects: Accuracy; advanced chronic kidney disease; Body composition; Body mass index; Care and treatment; Chronic kidney failure; Complications and side effects; Criteria; Diagnosis; Disease; Exercise; Female; Food Science; Frailty; Geriatrics; GLIM; Gériatrie; Hemodialysis; Human health sciences; Humans; Kidney diseases; Kidney Transplantation; Kidney transplants; Kidneys; Leadership; Likelihood ratio; Male; Malnutrition; Metabolism; Middle Aged; Mortality; muscle mass; Muscle strength; Nutrition; Nutrition and Dietetics; Nutrition Assessment; Nutritional Status; Older people; Performance assessment; phase angle; Phase shift; Physical fitness; prehabilitation; Product/Service Evaluations; Prognosis; Quality of life; Reference Standards; ROC Curve; Sciences de la santé humaine; Sensitivity analysis; Transplantation; Ultrasonic imaging; Values
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15051084

Malnutrition has a negative impact on patients with chronic diseases and its early identification is a priority. The primary objective of this diagnostic accuracy study was to assess the performance of the phase angle (PhA), a bioimpedance analysis (BIA)-derived parameter, for malnutrition screening using the Global Leadership Initiative for Malnutrition (GLIM) criteria as the reference standard in patients with advanced chronic kidney disease (CKD) waiting for kidney transplantation (KT); criteria associated with low PhA in this population were also analyzed. Sensitivity, specificity, accuracy, positive and negative likelihood ratios, predictive values, and area under the receiver operating characteristic curve were calculated for PhA (index test) and compared with GLIM criteria (reference standard). Of 63 patients (62.9 years old; 76.2% men), 22 (34.9%) had malnutrition. The PhA threshold with the highest accuracy was ≤4.85° (sensitivity 72.7%, specificity 65.9%, and positive and negative likelihood ratios 2.13 and 0.41, respectively). A PhA ≤ 4.85° was associated with a 3.5-fold higher malnutrition risk (OR = 3.53 (CI95% 1.0-12.1)). Considering the GLIM criteria as the reference standard, a PhA ≤ 4.85° showed only fair validity for detecting malnutrition, and thus cannot be recommended as a stand-alone screening tool in this population.