Could sarcopenia-related mortality in end-stage renal disease be underpinned by the number of hospitalizations and cardiovascular diseases?

• Published in: International urology and nephrology Vol. 55; no. 1; pp. 157 - 163
• Main Authors: de Luca Corrêa, Hugo, Gadelha, André Bonadias, Vainshelboim, Baruch, Dutra, Maurílio Tiradentes, Ferreira-Júnior, João B., Deus, Lysleine Alves, Neves, Rodrigo Vanerson Passos, Reis, Andrea Lucena, de Araújo, Thaís Branquinho, Tzanno-Martins, Carmen, Tavares, Fernanda Silveira, Andrade, Rosângela Vieira, dos Santos Rosa, Thiago
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.01.2023; Springer Nature B.V
• Subjects: Aged; Body mass index; Cardiovascular diseases; Cardiovascular Diseases - complications; Cardiovascular Diseases - epidemiology; Dual energy X-ray absorptiometry; End-stage renal disease; Fat-free body mass; Female; Hand Strength - physiology; Hemodialysis; Hospitalization; Humans; Kidney diseases; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Medicine; Medicine & Public Health; Mortality; Nephrology; Nephrology - Original Paper; Patients; Risk factors; Sarcopenia; Sarcopenia - complications; Sarcopenia - epidemiology; Urology; Nephrology; Hospitalization; Muscle strength; Cardiovascular diseases; Mortality; Muscle mass
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-022-03291-5

Purpose To investigate the association between sarcopenia with the number of all-cause mortality, hospitalizations, and cardiovascular diseases in patients with end-stage renal disease (ESRD). Methods 247 patients with ESRD (women, n  = 97) (66.6 ± 3.53 years) participated in this study. At baseline, all participants were measured with dual-energy X-ray absorptiometry and handgrip dynamometer and were prospectively followed up for 5 years. The European Working Group on Sarcopenia in Older People guidelines were utilized for Sarcopenia determination. Cox proportional hazard analysis adjusted for established risk factors was used to quantify the risk between Sarcopenia and all-cause mortality. Results Sixty-five participants (26%) were determined to have Sarcopenia at baseline and 38 (15%) have died during the follow-up. At baseline, Participants with Sarcopenia had lower body mass index and fat-free mass index. Moreover, through the 5-year follow-up, sarcopenic patients had higher number of cardiovascular disease (56.9% vs. 12.6%) and hospitalizations (93.8% vs. 49.5%) (all P  < 0.0001). Sarcopenia was associated with significantly higher risk of mortality, [Hazard ratio = 3.3, (95% CI: 1.6–6.9), P  = 0.001]. Conclusion Sarcopenia may be a risk factor for hospitalizations, cardiovascular diseases, and all-cause mortality in patients with ESRD. These results provide support of the relevance in assessing sarcopenia in the clinical practice of chronic kidney disease and how muscle mass and strength may negatively impact the daily life of ESRD patients undergoing hemodialysis. Greater efforts at preventing muscle wasting and malfunctioning are needed through the worldwide healthcare system.