High prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis

Abstract

Background and purposeSarcopenia is highly prevalent (28.5–40.3%) in patients undergoing hemodialysis and leads to poor clinical outcomes. However, the association between muscle quality and sarcopenia in patients receiving hemodialysis remains unclear. Therefore, we aimed to explore the association between muscle cross-sectional area (CSA) and proton-density fat-fraction (PDFF) in patients with sarcopenia undergoing hemodialysis.MethodsSeventy-six patients undergoing hemodialysis for > 3 months were enrolled. Their handgrip strength (HGS), short physical performance battery (SPPB) performance, and appendicular skeletal muscle mass index (ASMI) were measured. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 consensus update. All patients underwent quantitative magnetic resonance imaging. CSA and PDFF were measured for the thigh, trunk, and gluteus muscles.ResultsThe prevalence of probable, confirmed, and severe sarcopenia in this study was 73.7%, 51.3%, and 22.4%, respectively. Older age (OR: 1.061, P < 0.003); lower body mass index (BMI) (OR: 0.837, P = 0.008), albumin (OR: 0.765, P = 0.004), prealbumin (OR: 0.987, P = 0.001), predialysis blood urea nitrogen (BUN) (OR: 0.842, P < 0.001), predialysis creatinine (OR: 0.993, P < 0.001), phosphorus (OR: 0.396, P = 0.047); lower CSA of the thigh (OR: 0.58, P = 0.035), third lumbar (L3) trunk (OR: 0.37, P = 0.004), gluteus minimus and medius (OR: 0.28, P = 0.001), and gluteus maximus (OR: 0.28, P= 0.001); and higher PDFF of the thigh (OR: 1.89, P = 0.036) and L3 trunk (OR: 1.71, P = 0.040) were identified as sarcopenia risk factors. The gluteus minimus and medius CSA was lower in patients with sarcopenia than in those without after adjusting for age and BMI (OR: 0.37, P = 0.017). Higher thigh (P = 0.031) and L3 trunk (P = 0.006) muscle PDFF were significantly associated with lower HGS. Furthermore, higher thigh (P = 0.011) and L3 trunk (P = 0.010) muscle PDFF were also inversely correlated with lower ASMI.ConclusionOur findings demonstrate the high prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis and might trigger a paradigm shift in intervention strategies for patients receiving hemodialysis.

Concordance between muscle mass assessed by bioelectrical impedance analysis and by muscle ultrasound: a cross-sectional study in a cohort of patients on chronic hemodialysis

“…In addition, this percentage was much higher than that of the study by Abdala et al [ 29 ] who found that 16% of studied patients had sarcopenia. Also, our reported prevalence is slightly higher than that stated by Fu et al [ 30 ] who found that 51.3% of HD patients had confirmed sarcopenia. Furthermore, Anderson et al found a lower percentage of HD patients, compared to the current results, to have sarcopenia [ 31 ].…”

An Overview of Chronic Kidney Disease Pathophysiology: The Impact of Gut Dysbiosis and Oral Disease

“…Patients with CKD, especially those approaching ESRD failure and undergoing maintenance dialysis, frequently experience a gradual decline in their nutritional status [25]. The presence of unhealthy eating habits contributes to frailty in this population, as it leads to metabolic acidosis and nutrition imbalance exhibited as concurrent depletion of body protein and energy reserves, resulting in muscle wasting, sarcopenia, and cachexia [169,170]. In this context, metabolic acidosis plays an important role in accelerated protein catabolism, negative nitrogen balance, and loss of lean body mass in CKD and ESRD [171].…”