The diagnosis of sarcopenia is mainly driven by muscle mass in hemodialysis patients

Abstract

Background & aims: Sarcopenia is a well-known complication of protein energy wasting in hemodialysis patients. Its diagnosis requires measurements of muscle mass and muscle function. Few studies have reported its prevalence in hemodialysis patients. In this study, we report the prevalence of sarcopenia in this population and evaluate the performance of other parameters for its diagnosis.

Methods: In this observational cross-sectional study, data from hemodialysis patients from our nephrology department were recorded. Body composition measured by bioimpedancemetry analysis and muscle strength measured by handgrip were recorded. Normal values for sarcopenia were those recommended by the European Working Group on Sarcopenia in Older People (EWGSOP).

Results: The median age (interquartile range) of the 111 patients was 77.5 (70.8-84.8) years. A large majority of 88.3% (n = 98) of patients had a low muscle strength; a low muscle mass index was present in 33.3% (n = 37) of the population. Finally, 31.5% (n = 35) of patients had sarcopenia. These latter were older, had longer dialysis vintage, lower BMI, mid-arm circumference and mid-leg circumference, and a lower prealbumin. The best parameter predicting sarcopenia was BMI (ROC curve AUC of 0.79 [0.68-0.91] (p < 0.001) in men and 0.81 [0.68-0.93] (p = 0.003) in women). Mid-arm circumference predicted sarcopenia, but was less accurate than BMI. Mid-leg circumference predicted sarcopenia only in men. Predialysis creatinine or creatinine index could not predict sarcopenia.

Conclusions: We report a 31.5% prevalence of sarcopenia in hemodialysis patients. The diagnosis of sarcopenia was mainly driven by muscle mass measurement because muscle strength is low in the large majority of hemodialysis patients.

Keywords: Chronic hemodialysis; Chronic renal failure; Creatinine; Muscle mass; Muscle strength; Sarcopenia.