Prevalence and Risk Factors of Sarcopenia in Patients on Maintenance Hemodialysis: a Retrospective Cohort Study

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2024 May 31

PMID 38822297

Authors

Qianyun Zhao

Yuyu Zhu

Xin Zhao

Rui Shi

Tingting Lu

Ran Yu

Deguang Wang

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to explore the prevalence and related risk factors of sarcopenia in patients on maintenance hemodialysis (MHD).

Methods: This cohort study enrolled 165 patients on MHD. The patients were divided into sarcopenia and non-sarcopenia groups based on the presence of sarcopenia or not. Sarcopenia was diagnosed according to the consensus of the Asian Sarcopenia Working Group that considers reduced muscle mass and decreased muscle strength (19). The muscle mass was measured using the multi-frequency bioelectrical impedance (Inbody260) and skeletal muscle index (SMI) was used: <7.0 kg/m (male); <5.7 kg/m (female) - with muscle mass reduction. The electronic grip dynamometer was used for measuring dominant handgrip strength (HGS) to reflect muscle strength. Male patients with HGS < 28 kg and female patients with HGS < 18 kg were considered with a decrease in muscle strength. The demographic characteristics, laboratory indexes, anthropometrical measurements, body compositions, and InBody score were compared between groups. The multivariate logistic regression was used to explore the risk factors for sarcopenia.

Results: Of the 165 patients on MHD, 36 had sarcopenia, and the prevalence was 21.82%. Patients in the sarcopenia group had higher ages and lower body mass index, serum albumin level, circumference of waist, hip, and biceps, handgrip strength, total water content, protein inorganic salt concentrations, skeletal muscle mass, basal metabolic rate, obesity degree, SMI, and body fat content. The multivariate logistic regression showed that age, waist circumference, handgrip strength, and InBody score were influencing factors for sarcopenia in patients on hemodialysis.

Conclusion: The prevalence of sarcopenia was high in patients on MHD. Higher age, lower waist circumference, lower handgrip strength, and lower InBody score were independent risk factors for sarcopenia in such patients.

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References

Lamarca F, Carrero J, Rodrigues J, Bigogno F, Fetter R, Avesani C . Prevalence of sarcopenia in elderly maintenance hemodialysis patients: the impact of different diagnostic criteria. J Nutr Health Aging. 2014; 18(7):710-7. DOI: 10.1007/s12603-014-0505-5. View

Zanker J, Sim M, Anderson K, Balogun S, Brennan-Olsen S, Dent E . Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. J Cachexia Sarcopenia Muscle. 2022; 14(1):142-156. PMC: 9891980. DOI: 10.1002/jcsm.13115. View

Hashimoto Y, Takahashi F, Okamura T, Hamaguchi M, Fukui M . Diet, exercise, and pharmacotherapy for sarcopenia in people with diabetes. Metabolism. 2023; 144:155585. DOI: 10.1016/j.metabol.2023.155585. View

Coletta G, Phillips S . An elusive consensus definition of sarcopenia impedes research and clinical treatment: A narrative review. Ageing Res Rev. 2023; 86:101883. DOI: 10.1016/j.arr.2023.101883. View

Yoshimura Y, Wakabayashi H, Bise T, Tanoue M . Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients. Clin Nutr. 2017; 37(6 Pt A):2022-2028. DOI: 10.1016/j.clnu.2017.09.009. View

Cruz-Jentoft A, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T . Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2018; 48(1):16-31. PMC: 6322506. DOI: 10.1093/ageing/afy169. View

Bossola M, Hedayati S, Brys A, Gregg L . Fatigue in Patients Receiving Maintenance Hemodialysis: A Review. Am J Kidney Dis. 2023; 82(4):464-480. PMC: 11571972. DOI: 10.1053/j.ajkd.2023.02.008. View

Fahal I . Uraemic sarcopenia: aetiology and implications. Nephrol Dial Transplant. 2013; 29(9):1655-65. DOI: 10.1093/ndt/gft070. View

Alston H, Burns A, Davenport A . Loss of appendicular muscle mass in haemodialysis patients is associated with increased self-reported depression, anxiety and lower general health scores. Nephrology (Carlton). 2017; 23(6):546-551. DOI: 10.1111/nep.13075. View

10.

Kim N, Park Y, Kim N, Kim S . Weight-adjusted waist index reflects fat and muscle mass in the opposite direction in older adults. Age Ageing. 2020; 50(3):780-786. DOI: 10.1093/ageing/afaa208. View

11.

Janssen I . The epidemiology of sarcopenia. Clin Geriatr Med. 2011; 27(3):355-63. DOI: 10.1016/j.cger.2011.03.004. View

12.

Leenders M, Verdijk L, van der Hoeven L, Adam J, van Kranenburg J, Nilwik R . Patients with type 2 diabetes show a greater decline in muscle mass, muscle strength, and functional capacity with aging. J Am Med Dir Assoc. 2013; 14(8):585-92. DOI: 10.1016/j.jamda.2013.02.006. View

13.

Carrero J, Johansen K, Lindholm B, Stenvinkel P, Cuppari L, Avesani C . Screening for muscle wasting and dysfunction in patients with chronic kidney disease. Kidney Int. 2016; 90(1):53-66. DOI: 10.1016/j.kint.2016.02.025. View

14.

Edwards M, Dennison E, Aihie Sayer A, Fielding R, Cooper C . Osteoporosis and sarcopenia in older age. Bone. 2015; 80:126-130. PMC: 4601530. DOI: 10.1016/j.bone.2015.04.016. View

15.

Beaudart C, Reginster J, Petermans J, Gillain S, Quabron A, Locquet M . Quality of life and physical components linked to sarcopenia: The SarcoPhAge study. Exp Gerontol. 2015; 69:103-10. DOI: 10.1016/j.exger.2015.05.003. View

16.

Olvera-Soto M, Valdez-Ortiz R, Alvarenga J, Espinosa-Cuevas M . Effect of Resistance Exercises on the Indicators of Muscle Reserves and Handgrip Strength in Adult Patients on Hemodialysis. J Ren Nutr. 2015; 26(1):53-60. DOI: 10.1053/j.jrn.2015.06.006. View

17.

Moorthi R, Avin K . Clinical relevance of sarcopenia in chronic kidney disease. Curr Opin Nephrol Hypertens. 2017; 26(3):219-228. PMC: 5860815. DOI: 10.1097/MNH.0000000000000318. View

18.

Kim J, Choi S, Choi M, Kim S, Lee Y, Noh J . Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease. Clin Nutr. 2013; 33(1):64-8. DOI: 10.1016/j.clnu.2013.04.002. View

19.

Yuan S, Larsson S . Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism. 2023; 144:155533. DOI: 10.1016/j.metabol.2023.155533. View

20.

Bennett J, Pratt A, Dodds R, Sayer A, Isaacs J . Rheumatoid sarcopenia: loss of skeletal muscle strength and mass in rheumatoid arthritis. Nat Rev Rheumatol. 2023; 19(4):239-251. DOI: 10.1038/s41584-023-00921-9. View