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

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. 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. 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). 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.