Influence of albumin and phase angle on the survival of patients with chronic kidney disease on hemodialysis: a prospective study.

Introduction: Hemodialysis (HD) prolongs the survival of patients with end-stage chronic kidney disease (CKD), but mortality remains high due to malnutrition and inflammation. This study aimed to investigate whether low albumin levels and a reduced phase angle (PA) predict higher mortality in HD patients.

Methods: This prospective cohort study followed 82 HD patients for 36 months. Biological markers, including albumin and oxidative stress indicators, were measured before and after a single HD session upon study enrollment (time zero). PA was determined by bioimpedance analysis. Kaplan-Meier survival curves and Cox regression analyses were performed to assess the association between albumin, PA, and mortality.

Results: Patients with PA <4 had a mean survival of 11.6 months, compared to 27.0 months for those with PA ≥ 4 (HR = 5.66; 95% CI: 2.44-13.12). Similarly, patients with albumin <3.9 g/dL had significantly lower survival rates at 6, 12, and 36 months compared to those with albumin ≥3.9 g/dL (HR = 4.39; 95% CI: 1.81-10.63).

Conclusion: Low albumin levels and a reduced PA are strong predictors of mortality in HD patients. Routine monitoring and targeted interventions to improve these markers could enhance survival outcomes.