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Hemodialysis II: Procedure and Complications

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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Phase angle variability on bleeding risks in hemodialysis patients.

Masayuki Ohta1, Toshiro Kan2, Yuichi Yoshida2

  • 1Department of Dialysis, Higashi Naebo Hospital, 2-18, Higashi-Naebo 3-Jo 1-Chome, Higashi Ward, Sapporo, Hokkaido, 007-0803, Japan. masayukidakido@gmail.com.

Clinical and Experimental Nephrology
|October 15, 2024
PubMed
Summary

Phase Angle (PhA) measured by bioelectrical impedance analysis is a significant predictor of bleeding risk in hemodialysis patients. Lower PhA levels indicate a higher likelihood of bleeding events, suggesting its utility in risk stratification.

Keywords:
Bioelectrical impedance analysisBleeding riskFrailtyHemodialysisMalnutritionPhase angle

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Area of Science:

  • Nephrology
  • Clinical Nutrition
  • Biomarkers

Background:

  • Bleeding events pose a significant risk for patients undergoing hemodialysis.
  • Predictive markers for bleeding risk in this population are crucial for clinical management.
  • Phase Angle (PhA) measured by bioelectrical impedance analysis is a potential, yet understudied, indicator.

Purpose of the Study:

  • To investigate the association between Phase Angle (PhA) and the risk of bleeding in hemodialysis patients.
  • To evaluate the utility of PhA as a predictive marker for major bleeding events.
  • To explore the role of PhA in stratifying bleeding risk within the hemodialysis cohort.

Main Methods:

  • A retrospective cohort study involving 102 hemodialysis patients with PhA measurements.
  • Collection of demographic, clinical, and dialysis-related data, including bleeding events.
  • Statistical analyses included multivariate Cox proportional hazards regression and Kaplan-Meier survival analysis.

Main Results:

  • Lower PhA was identified as an independent risk factor for major bleeding events (HR: 0.24, p < 0.001).
  • Patients with PhA ≥ 4.00 demonstrated a significantly higher probability of remaining free from major bleeding at 2 years (94.3%) compared to those with PhA < 4.00 (75.0%).
  • Analysis of repeat PhA measurements further supported the predictive value of PhA in assessing bleeding event-free rates.

Conclusions:

  • Phase Angle (PhA) serves as a valuable predictive marker for bleeding risk in hemodialysis patients.
  • Routine monitoring of PhA can aid in identifying high-risk individuals.
  • Integrating PhA assessment into clinical practice may optimize the management of bleeding risk in hemodialysis.