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Background: Sarcopenia is a common complication in end-stage renal disease. Low muscle strength and muscle mass are risk factors for cardiovascular disease and mortality in patients undergoing dialysis. We studied the relation between sarcopenia and pre-atherosclerotic markers and its effect on cardiovascular events and death in dialysis patients. Methods: We measured muscle strength, muscle mass, carotid intima-media thickness, and pulse wave velocity in 106 patients. Sarcopenia was diagnosed according to the EWGSOP-2 suggestions. Patients with low muscle strength and low muscle mass were considered sarcopenic. The follow-up period for cardiovascular events and mortality was 24 months. Results: The mean age and dialysis duration were 57.4 ± 16.6 and 6.5 ± 4.9 years, respectively. Of all patients, 53 (50%) were male and 70 (66%) were on hemodialysis treatment. Sarcopenia and low muscle strength were seen in 47.1% and 88.7%, respectively. Hemodialysis patients were more likely to be sarcopenic than peritoneal dialysis patients (p = 0.001). Ferritin and Kt/V levels were higher, and body mass index was lower significantly in sarcopenic patients (p < 0.001). There was no significant difference in carotid intima-media thickness and pulse wave velocity measurements between the groups (p = 0.62 and p = 0.68, respectively). There was no statistically significant difference in cardiovascular events and mortality in cases with and without sarcopenia (p = 0.43 and p = 0.17, respectively). Conclusion: There was no association between sarcopenia and pre-atherosclerotic markers, cardiovascular events, and allcause mortality in dialysis patients. Techniques to detect low muscle strength and muscle mass need standardization, and new specific cut-off levels must be defined for dialysis patients. | INTRODUCTIONSarcopenia, first described as a geriatric syndrome with reduced physical performance and muscle strength, is characterized by skeletal muscle loss which is generalized and progressive. It causes functional impairment and physical disability and is associated with an increased risk of fall, fracture, disability, hospitalization, and even mortality in the elderly. 1,2 The aging process is accelerated in patients with end-stage renal disease (ESRD). This may in part be a result of accelerated protein catabolism induced by metabolic acidosis, uremia, proteinuria, proinflammatory cytokines, mineral bone disorders, and insulin resistance. 3 The growing data on the effect of sarcopenia on long-termThe impact of sarcopenia on cardiovascular events and mortality in dialysis patients is not clear. The methods we should use to diagnose sarcopenia in this particular group of patients are still controversial. This study evaluates the issue and focuses on the need for standardization and definition of particular cut-off points.

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Background and Aims There is a hesitation in returning peritoneal dialysis (PD) after kidney transplant (KTx) failure. Studies in larger multicentre matched cohorts are missing. Method We conducted a retrospective study about 19 patients who started PD after KTx failure (PDpostTx group) between January 2010 and August 2022 in Ankara University School of Medicine who were compared with 70 never-transplanted patients having started PD during the same period (PDnoTx group). Patients’ clinical data and PD technique survival as well as peritonitis episodes were analysed. Results Mean age was 51 years and continuous ambulatory PD was the treatment of choice (59.6%) (Table 1). Even the mean time on PD was similar between groups (45.4 months in PDpostTx vs 51.7 months in PDnoTx, p = 0.525), transfer to HD was more common in PDpostTx patients (36.8% vs 10.0%, p = 0.015). The main cause of transfer to HD was ultrafiltration failure, which was significantly higher in PDpostTx group (p = 0.002). Diuresis at baseline was similar between groups, but decreased significantly in PDpostTx group at first year and final follow-up (p &lt; 0.001, and p = 0.001, respectively). Peritonitis was more common in PDpostTx group (68.4% vs 30.0%, p = 0.002). Diabetes mellitus was a risk factor for peritonitis episode (p = 0.012), but we didn’t observe any effect of immunosuppressive therapy on peritonitis and reduction of the diuresis. In multivariate analysis, KTx failure (p = 0.014), peritonitis episodes (p = 0.011) and ultrafiltration failure (p &lt; 0.001) were associated with a higher risk of transfer to HD. Over the study period, patients’ survival was similar between groups (p = 0.766). Conclusion We reported similar patient survival, but higher peritonitis rates and PD technique failure in the PDpostTx group, when compared to patients who started PD for other reasons. Considering these findings, taking precautions against peritonitis is more important for patients who started PD after KTx failure.