Association of Fat Mass with SARC-F in Older Patients Undergoing Haemodialysis.

BACKGROUND/OBJECTIVES: An increase in fat mass is accompanied by a loss of muscle mass and function in chronic kidney disease. However, no studies in haemodialysis (HD) patients have investigated the relationship between fat mass and sarcopenia. The primary aim of this study is to assess the prevalence of sarcopenia, while the secondary aim is to verify the association between the fat mass percentage and SARC-F and SARC-F combined with calf circumference (SARC-F+CC) in elderly HD patients. SUBJECTS/METHODS: A cross-sectional study enrolled 96 HD older patients (male, n = 66). SARC-F ≥4 is used to define the muscle function loss, whereas SARC-F ≥6 or SARC-F ≥11 (with the calf circumference added) are the thresholds to diagnose sarcopenia. The fat mass percentage is obtained using bioelectrical impedance analysis. RESULTS: We found that 37.5% had a risk of muscle function loss due to SARC-F ≥4, 21.8% risk of sarcopenia using the SARC-F ≥6, and when using CC, the prevalence of risk of sarcopenia increased to 41.6% according to SARC-F+CC ≥11. In addition, there was an association between adiposity and sarcopenia for SARC-F ≥6 (OR: 1.25, p= 0.028) and SARC-F+CC ≥11 (OR: 1.25, p= 0.0003), but not with muscle function loss (SARC-F ≥4). CONCLUSION: In conclusion, we found that 37.5% of HD patients had a risk of muscle function loss and 21-41% presented sarcopenia, depending on the cut-off point used. In addition, higher adiposity was associated with an increased likelihood of having sarcopenia by 25%.

Fatigue Is Not Associated with Phase Angle in Hemodialysis Patients.

PURPOSE: The aim of this study was to investigate the association between fatigue and phase angle (PA) in patients with chronic kidney disease (CKD) on hemodialysis (HD). METHODS: A cross-sectional study with older patients than 18 years diagnosed with CKD undergoing HD. From 160 (58.36±15.05 years) patients, (n=96; 60%) are men. Body mass and height were assessed using a portable scale and stadiometer, followed by body mass index (BMI) calculus. The bioimpedance electrical analysis was performed using the Bodystat QuadScan 4000. The sample size was dichotomized in two groups, using the median of our sample, either normal when PA ≥5.4º, or low when the PA <5.4º. The Chalder fatigue questionnaire was used the assess the fatigue. The multiple regression was applied to assess the association between fatigue questionnaire and PA. RESULTS: Were considered normal PA≥5.4º (n=78, 48.8%) and low PA<5.4º (n=82, 51.2%). The patients of the PA<5.4º group are older compared to the PA≥5.4º group (63.1±15.1 vs. 53.3±13.4 years, p<0.001). There was no association between PA and fatigue score in the crude model (OR: 1.02, 95%CI: 0.96-1.08, p=0.47) and after confounding variables (OR: 1.03, CI: 0.95-1.12, p=0.43). CONCLUSIONS: In HD patients, we found that patients with lower PA values are older. In addition, we did not find association between fatigue and PA.

25OH Vitamin D Is No Associated with Muscle Function Loss in Adults and Elderly Patients Undergoing Hemodialysis.

OBJECTIVES: In patients with chronic kidney disease, sarcopenia is associated with dialysis treatment, accelerated protein catabolism, and high energy demand. Thus, this study aimed to assess the association between 25-OH vitamin D concentrations and muscle function in patients undergoing hemodialysis. DESIGN: A cross-sectional study. SETTING: Performed in a hemodialysis clinic. PARTICIPANTS: 79 adult and elderly patients undergoing hemodialysis. MEASUREMENTS: The sample was divided according to the SARC-F definition, being 55 patients allocated in the SARC-F <4 group and 24 in the SARC-F ≥4 group. Normal 25-OH vitamin D concentrations was considered when ≥30 ng/dL. RESULTS: Vitamin D concentrations and number of patients with low or normal muscle function did not differ between the groups. There was no correlation between SARC-F and 25-OH vitamin D levels (r: -0.09, p=0.42). CONCLUSIONS: 25-OH vitamin D has no association with muscle function loss in adults and elderly patients undergoing hemodialysis.

SARC-F Is Better Correlated with Muscle Function Indicators than Muscle Mass in Older Hemodialysis Patients.

BACKGROUND: Sarcopenia can be characterized by European Consensus for Sarcopenia (EWGSOP2) criteria, but it methods are not easily accessible. Likewise, the Strength, Assistance with walking, Rise from a Chair, Climb stairs and Falls (SARC-F) has been proposed. OBJECTIVE: The aim of this study was i) to evaluate the prevalence for risk sarcopenia and ii) to correlate the SARC-F with components of the EWGSOP2 consensus in hemodialysis (HD) patients. MEASUREMENTS: This cross-sectional study enrolled ninety-five (male n= 59; 62%) HD older patients. Sarcopenia risk was assessed using the SARC-F, which ≥4 score indicates sarcopenia risk. Sarcopenia was confirmed through of the EWGSOP2 consensus, including the handgrip strength (HGS <27kg for men and <16kg for women) using the dynamometer, muscle mass through appendicular muscle mass (ASMI/m2 <7.0 kg/m2 for men and 5.5 kg/m2 for women) using the bioimpedance electrical, and physical performance through of gait speed (GS <0.8 m/s). RESULTS: From 95 patients, n=21(22%) presented sarcopenia risk. SARC-F ≥4 group are older (64.9±13.9 vs. 56.9±14.6 y, p= 0.028), presented lower ASMI (7.4±1.2 vs. 8.3±1.8 kg/m2, p=0.033), HGS (20.5±5.7 vs. 27.2±10.2 kg, p=0.005), and GS (0.5±0.1 vs. 0.7±0.1 m/s, p=0.001) than SARC-F<4 group. SARC-F score was negatively correlated with EWGSOP2 components: ASMI x SARC-F (r=-0.27, p=0.007), HGS x SARC-F (r=-0.35, p=0.0005), and GS x SARC-F (r=-0.47, p<0.0001). Although, no difference of number of patients with low or normal ASMI values was found, 62% and 95% of SARC-F≥4 group patients presented low HGS and gait speed, respectively. CONCLUSIONS: In older HD patients, 22% presented sarcopenia risk. In addition, SARC-F is better correlated with muscle function indicators (HGS and gait speed) than muscle mass.