Relationship between disability in activities of daily living and phase angle in hemodialysis patients

Background: To investigate the prevalence of disability in activities of daily living (ADL) in hemodialysis patients and its relationship withphase angle (PhA). Methods: : Maintenance hemodialysis patients between November 2019 and January 2020 in a Chinese university hospital were enrolled. Physical function was measured by the basic ADL (BADL) and instrumental ADL (IADL) scales. The association of disability in ADL with PhA was identified by univariable and multivariable logistic regression analysis. The receiver operating characteristic (ROC) curve was used to analyze PhA and to determine the optimal cut-off value of PhA for disability in ADL. Results: : This study included 237 hemodialysis patients with a mean age of 60.01 ± 13.55 years. The prevalence of disability in ADL was 43.5%. According to the multivariable analysis, which took age, sex, body mass index, history of hypertension and diabetes mellitus, and duration of dialysis into account, low PhA was shown to be strongly associated with disability in BADL and IADL (per unit decrease of PhA: odds ratio 4.37 [95% CI: 2.49–7.63], and 3.19 [95% CI: 2.03–5.05], respectively). The optimal cut-off values of PhA for disability in BADL and IADL were 4.8 and 5.4, with the area under the ROC curve (AUC) of 0.783 (0.727, 0.835) and 0.799 (0.743, 0.848), respectively. Additionally, females had higher AUC values than males. Conclusions: : Low PhA is strongly associated with disability in ADL in hemodialysis patients. Moreover, PhA is helpful in screening for disability in ADL.