الفهرس | Only 14 pages are availabe for public view |
Abstract Sarcopenia, a progressive loss of skeletal muscle mass and strength, is a prevalent condition among patients with CKD, particularly those undergoing hemodialysis. Sarcopenia in HD patients is associated with adverse outcomes, including physical disability, poor quality of life, increased cardiovascular risk, and higher mortality rates. This study aimed to evaluate the prevalence and associated factors contributing to sarcopenia in a cohort of regular HD patients, providing valuable insights for the development of targeted interventions and strategies to mitigate the burden of this condition. This cross-sectional study evaluated factors affecting sarcopenia in 86 regular HD patients. The participants were divided into three groups based on the presence and severity of sarcopenia according to the EWGSOP2 criteria: group I (without sarcopenia, n=31), group II (pre-sarcopenia, n=14), and group III (sarcopenia, n=41). Sarcopenia was defined as the coexistence of low muscle strength, assessed by handgrip strength, and reduced muscle quantity measured by mid-arm muscle circumference and BIA. Appendecular Skeletal Muscle mass index (ASMI) was calculated from BIA data. Additionally, the SGA score and biochemical parameters were evaluated for each participant The results demonstrated a high prevalence of sarcopenia among HD patients with 47.7% of the studied population being diagnosed with sarcopenia according to the EWGSOP2 criteria. The results also demonstrated a significant difference was observed in dialysis vintage with sarcopenic patients having a longer duration of dialysis secondary to chronic catabolic state, muscle wasting, decreased muscle endurance, increased oxidative stress and chronic inflammation. Statistical analysis also identified that DM was significantly higher in the sarcopenic group. This may be explained by insulin resistance, chronic inflammation, and impaired protein synthesis. Anthropometric measurements revealed a lower mean values of dry body weight and BMI compared to the non-sarcopenic group reflecting a poor oral intake, malnutrition, and poor nutritional status. Sarcopenia assessment using ASMI, handgrip strength, and MAC, revealed lower mean values for all these measures compared to the non sarcopenic group reflecting the reduced muscle mass and strength associated with sarcopenia. Nutritional status assessment using SGA score and serum albumin showed a higher prevalence of severe malnutrition in the sarcopenic group compared to the other groups secondary to multiple factors including insufficient dietary intake and a loss of nutrients through the dialysate, or an increased muscle breakdown due to inflammation or metabolic acidosis. Laboratory data analysis revealed significant low levels of hemoglobin, creatinine and Kt/V in sarcopenic patients indicating that anemia, low muscle mass and insufficient dialysis are risk factors for development of sarcopenia in hemodialysis patients. Laboratory data analysis also revealed significant high levels of cholesterol, triglycerides, and CRP in sarcopenic patients denoting that dyslipidemia and inflammation are risk factors for development of sarcopenia in such group. |