Abstract: Objective To evaluate the predictive value of bioelectrical impedance phase angle (PhA) for
hypoalbuminemia in maintenance hemodialysis (MHD) patients. Methods This was a single-center and crosssectional study. A total of 136 patients who underwent MHD in our center in March 2021 were enrolled. Their
basic information, biochemical indicators, dialysis-related indicators and pre-dialysis bioelectrical impedance
measurement data were collected. The patients were divided into a hypoalbuminemia group (34 cases) and a
non-hypoproteinemia group (102 cases). Clinical characteristics of the two groups were compared. Univariate
and multivariate analysis were used to identify the related factors of hypoalbuminemia. The diagnostic value
of PhA for hypoalbuminemia was analyzed using the receiver operating characteristic curve (ROC). Results
Compared with the non- hypoalbuminemia group, the hypoalbuminemia group had lower PhA (Z=8.715,
P<0.001). Spearman's analysis showed that PhA and serum albumin were positively correlated (r=0.609,
P<0.001). Multivariate dichotomous logistic regression showed that lower PhA and serum calcium were the
independent factors for hypoalbuminemia in MHD patients (OR=5.148, 95% CI: 2.550～10.394, P<0.001;
OR=15.857, 95% CI: 1.302～193.170, P=0.030). ROC curve suggested that the optimal cut-off value of PhA
for the diagnosis of hypoalbuminemia in MHD patients was 3.85° (AUC=0.815, 95% CI: 0.736～0.895,
P＜0.001). Conclusion Lower PhA value is an independent influencing factor for hypoalbuminemia in
MHD patients.

Key words: Maintenance hemodialysis; , Hypoalbuminemia; , Bioelectrical impedance analysis; , Phase angle