Bioelectrical Impedance Analysis Measures and Clinical Outcomes in CKD
Bioelectrical Impedance Analysis Measures and Clinical Outcomes in CKD
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DOI：
10.1053/j.ajkd.2018.03.030
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发表时间：
2018-11-01
影响因子：
13.2
通讯作者：
Chertow, Glenn M.
中科院分区：
文献类型：
--
作者：
Bansal, Nisha;Zelnick, Leila R.;Chertow, Glenn M.
原理和目的：生物电阻抗分析（BIA）提供了一种无创的身体成分评估。细胞完整性（相位角）和水合作用（矢量长度）的BIA测量与接受透析的患者的死亡率相关。这些指标是否与慢性肾脏病（CKD）患者的临床结局相关尚不清楚。研究设计：观察性研究。设置和参与者：我们研究了前瞻性多中心慢性肾功能不全队列（CRIC）中的3，751名CKD参与者，他们进行了基线单频BIA。预测因素：预测因子包括相位角和矢量长度，这是从BIA的电阻和电抗的测量计算。我们将相位角和向量长度分为四分位数，并将相位角的2个较窄的四分位数和向量长度的2个较短的四分位数与2个较高的四分位数进行比较。（估计肾小球滤过率下降30%或终末期肾病）。分析方法：我们使用考克斯比例风险模型测试了相位角和矢量长度与死亡率和慢性肾脏病进展风险的相关性，并使用Fine和Gray模型测试了与心力衰竭和动脉粥样硬化性心血管疾病的相关性。所有模型均根据人口统计学、共病情况和肾功能进行调整。结果：平均相位角和向量长度分别为6.6度± 1.8度和470 ± 96 Ω/m。相对于相位角>= 6.40度，更窄的相位角（= 459 Ω/m，更短的矢量长度（
Rationale & Objective: Bioelectrical impedance analysis (BIA) provides a noninvasive assessment of body composition. BIA measures of cell integrity (phase angle) and hydration (vector length) have been associated with mortality among patients receiving dialysis. Whether these measures are associated with clinical outcomes in patients with chronic kidney disease (CKD) is unknown.Study Design: Observational study.Settings & Participants: We studied 3,751 participants with CKD in the prospective multicenter Chronic Renal Insufficiency Cohort (CRIC) who had baseline single-frequency BIA performed.Predictors: Predictors included phase angle and vector length, which were calculated from measurements of resistance and reactance from BIA. We ranked phase angle and vector length into quartiles and compared the 2 narrower quartiles of phase angle and shorter quartiles of vector length with the 2 upper quartiles.Outcomes: Mortality, heart failure, atherosclerotic cardiovascular disease, and progression of CKD (30% decline in estimated glomerular filtration rate or end-stage kidney disease).Analytic Approach: We tested associations of phase angle and vector length with risks for mortality and progression of CKD using Cox proportional hazard models and the association with heart failure and atherosclerotic cardiovascular disease using Fine and Gray models. All models were adjusted for demographics, comorbid conditions, and kidney function.Results: Mean phase angle and vector length were 6.6 degrees +/- 1.8 degrees and 470 +/- 96 Omega/m, respectively. Relative to phase angle >= 6.40 degrees, narrower phase angle (= 459 Omega/m, shorter vector length (