The PHASE ANGLE AND ITS CLINICAL RELEVANCE TO MALNUTRITION AND LOW-GRADE INFLAMMATION AMONG HEMODIALYSIS PATIENTS: A CROSS-SECTIONAL PERSPECTIVE

ESTI WIDIASIH — 2025-08-02

Background: Patients with chronic kidney disease (CKD) undergoing routine hemodialysis are prone to chronic inflammation and malnutrition, two interrelated conditions that worsen clinical outcomes. The phase angle obtained from bioelectrical impedance analysis (BIA) reflects cell membrane integrity and nutritional status and is suspected to correlate with inflammatory biomarkers such as TNF-α.

Objective: To analyze the relationship between phase angle and Dialysis Malnutrition Score (DMS) on TNF-α levels in routine hemodialysis patients.

Methods: A cross-sectional analytical study was conducted on 50 routine hemodialysis patients in a clinic in Semarang. Data collected included age, sex, duration of hemodialysis, BMI, skeletal muscle mass (SMM), DMS, phase angle, and TNF-α levels. Data were analyzed using Pearson correlation and multiple linear regression.

Results: The average age of participants was 52.38 years, and the average phase angle was 5.05. Pearson correlation showed a significant negative correlation between phase angle and TNF-α levels (r = -0.587; p = 0.000), while DMS showed a positive correlation (r = 0.368; p = 0.009). In the regression model, only phase angle was a significant predictor of TNF-α (β = -0.471; p < 0.001).

Conclusion: Phase angle has a significant negative correlation with TNF-α levels, suggesting its potential as a non-invasive marker for inflammation monitoring in hemodialysis patients. DMS was not significant in the multivariate model. Further studies are recommended to explore causal relationships and longitudinal assessments.

Keyword : Hemodialysis, Phase Angle, TNF-α, Malnutrition, DMS, Chronic Inflammation

THE EFFECTS OF VITAMIN D SUPPLEMENTATION ON DISEASE ACTIVITY IN SYSTEMIC LUPUS ERYTHEMATHOSUS PATIENTS: AN EVIDENCE-BASED CASE REPORT

Santri Dwizamzami Faridahanum — 2025-09-28

Background: Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease characterized by the production of autoantibodies and multisystem involvement, predominantly affecting women of reproductive age. Vitamin D is known to have immunomodulatory effects, including inhibition of T and B cell activation and suppression of pro-inflammatory cytokine production. Objectives: This evidence-based case report aims to evaluate the effect of vitamin D supplementation on disease activity in SLE. Methods: A literature search was conducted using PubMed, Scopus, and Cochrane. Medical Subject Headings (MeSH) terms and relevant keywords based on the clinical question components were applied. All retrieved literature was screened using predefined eligibility criteria, followed by a critical appraisal of eligible studies. Results: One meta-analysis of randomized controlled trials (RCTs) and two RCTs met the eligibility criteria. Almost all of the included studies recruited patients with SLE who had vitamin D deficiency/insuficiency. The methodological validity of all three studies was considered acceptable. The studies demonstrated heterogeneity in terms of baseline disease activity levels among their study populations. The meta-analysis and one of the RCTs reported non-significant results, while the other RCT showed a significant improvement in disease activity following vitamin D supplementation. Conclusion: Current evidence is insufficient to recommend vitamin D supplementation as an adjuvant therapy for improving disease activity in patients with SLE and further research is needed.

IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN)

The PHASE ANGLE AND ITS CLINICAL RELEVANCE TO MALNUTRITION AND LOW-GRADE INFLAMMATION AMONG HEMODIALYSIS PATIENTS: A CROSS-SECTIONAL PERSPECTIVE

THE EFFECTS OF VITAMIN D SUPPLEMENTATION ON DISEASE ACTIVITY IN SYSTEMIC LUPUS ERYTHEMATHOSUS PATIENTS: AN EVIDENCE-BASED CASE REPORT