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. 2023 Feb 21;15(5):1084.
doi: 10.3390/nu15051084.

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

Elena Muñoz-Redondo  1   2   3 , Andrea Morgado-Pérez  1   2 , María-José Pérez-Sáez  4   5   6 , Anna Faura  4 , Dolores Sánchez-Rodríguez  7   8   9 , Marta Tejero-Sánchez  1   2 , Delky Meza-Valderrama  2   10 , María Dolors Muns  11 , Julio Pascual  12 , Ester Marco  1   2   6
Affiliations

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

Elena Muñoz-Redondo et al. Nutrients. .

Abstract

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.

Keywords: GLIM; advanced chronic kidney disease; malnutrition; muscle mass; phase angle; prehabilitation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
STARD diagram reporting flow of participants (n = 64).
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve for prediction of malnutrition based on the GLIM criteria.
Figure 3
Figure 3
Post-test positive (blue line) and negative (red line) probabilities of malnutrition in candidates on the waiting list for kidney transplantation (left) and in the subgroup of subjects with BMI < 25 kg/m2 (right). Nomograms computed with the ‘Diagnostic Test Calculator’ (available at araw.mede.uic.edu).
See this image and copyright information in PMC

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