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Factors Associated with Sarcopenia among Hemodialysis Patients

혈액투석환자의 근감소증 관련요인

  • Received : 2022.01.07
  • Accepted : 2022.02.14
  • Published : 2022.02.28

Abstract

Purpose : This descriptive survey aims to identify the prevalence of factors associated with sarcopenia among hemodialysis patients. Methods : The study subjects were 137 patients with chronic kidney failure undergoing hemodialysis in three artificial kidney centers in B and Y cities. Data were collected from August 1 to September 30, 2020, using the SARC-F (Strength, Assistant walking, Rising from a chair, Climbing stairs, Falls) questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF), International Physical Activity Questionnaire (IPAQ-SF), Bioelectrical Impedance Analysis (BIA), and a grip dynamometer. The collected data were analyzed using t-tests, crossover analysis, and logistic regression using the IBM SPSS 23 program. Results : The prevalence of sarcopenia among hemodialysis patients, determined using the SARC-F questionnaire, was 16.1%. The associated factors of sarcopenia among hemodialysis patients were found to be gender (OR=6.44, p =.002), age (OR=1.07, p =.015), nutritional status (OR=10.37, p =.027), and albumin level (OR=0.10, p =.014). These findings are supported by an explanatory power of 46.3% (p =.597). Conclusion : The identified risk factors for sarcopenia in hemodialysis patients were; sex, age, nutritional status, and albumin level. The findings of this study can serve as clinical evidence for the development of an intervention program for preventing and managing sarcopenia in patients undergoing hemodialysis.

Keywords

References

  1. The Korean Society for Dialysis Therapy. Hemodialysis [Internet]. Seoul: The Korean Society for Dialysis Therapy; 2013 [cited 2012 December 20]. Available from: http://www.e-kda.org/blood/sub01.html
  2. Hong YA, Ban TH, Kang CY, Hwang SD, Choi SR, Lee H, et al. Trends in epidemiologic characteristics of end-stage renal disease from 2019 Korean renal data system (KORDS). Kidney Research and Clinical Practice. 2021;40(1):52-61. https://doi.org/10.23876/j.krcp.20.202
  3. Cruz-Jentoft A, Baeyens JP, Bauer J, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age & Ageing. 2010;39(4):412-23. https://doi.org/10.1093/ageing/afq034
  4. Lee On, Kim Y. Association between grip strength as diagnostic citeria of sarcopenia and healthrelated quality of life in Korean elderly. The Korean Journal of Sport Medicine. 2018;36(1):15-23. https://doi.org/10.5763/kjsm.2018.36.1.15
  5. Kim HH, Kim JS, Yu JO. Factors contributing to sarcopenia among community-dwelling older Korean adults. Journal of Korean Gerontological Nursing. 2014;16(2):170-9. https://doi.org/10.17079/jkgn.2014.16.2.170
  6. Stenvinkel P, Carrero JJ, von Walden F, Ikizler TA, Nader GA. Muscle wasting in end-stage renal disease promulgates premature death: established, emerging and potential novel treatment strategies. Nephrology Dialysis Transplantation. 2016;31(7):1070-77. https://doi.org/10.1093/ndt/gfv122
  7. Giglio J, Kamimura MA, Lamarca F, Rodrigues J, Santin F, Avesani CM. Association of sarcopenia with nutritional parameters, quality of life, hospitalization, and mortality rates of elderly patients on hemodialysis. Journal of Renal Nutrition. 2018;28(3):197-207. https://doi.org/10.1053/j.jrn.2017.12.003
  8. Bataille S, Serveaux M, Carreno E, Pedinielli N, Darmon P, Robert A. The diagnosis of sarcopenia is mainly driven by muscle mass in hemodialysis patients. Clinical Nutrition. 2017;36(6):1654-60. https://doi.org/10.1016/j.clnu.2016.10.016
  9. Kim J, Choi SR, Choi MJ, Kim SG, Lee YK, Noh JW, et al. Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease. Clinical Nutrition. 2014;33(1):64-8. https://doi.org/10.1016/j.clnu.2013.04.002
  10. Lin Y, Wang C, Lai Y, Kuo C, Hsu B, Liou H, et al. Impact of sarcopenia and its diagnostic criteria on hospitalization and mortality in chronic hemodialysis patients: a 3-year longitudinal study. Journal of the Formosan Medical Association. 2020;119(7):1219-29. https://doi.org/10.1016/j.jfma.2019.10.020
  11. Lee SW. Protein-energy wasting in dialysis patients : causes and treatment. The Korean Journal of Nephrology. 2009;28(4):279-85.
  12. Carrero JJ, Stenvinkel P, Cuppari L, Ikizler TA, Kalantar-Zadeh K, Kaysen G, et al. Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the international society of renal nutrition and metabolism (ISRNM). Journal of Renal Nutrition. 2013;23(2):77-90. https://doi.org/10.1053/j.jrn.2013.01.001
  13. Stenvinkel P, Ketteler M, Johnson RJ, Lindholm B, Pecoits-Filho R, Riella M, et al. IL-10, IL-6, and TNF-alpha: central factors in the altered cytokine network of uremia-the good, the bad, and the ugly. Kidney International. 2005;67(4):1216-33. https://doi.org/10.1111/j.1523-1755.2005.00200.x
  14. Johansen KL, Delgado C, Bao Y, Tamura MK. Frailty and dialysis initiation. Seminars in Dialysis. 2013;26(6):690-6. https://doi.org/10.1111/sdi.12126
  15. Bossola M, Luciani G, Rosa F, Tazza L. Appetite and gastrointestinal symptoms in chronic hemodialysis patients. Journal of Renal Nutrition. 2011;21(6):448-54. https://doi.org/10.1053/j.jrn.2010.09.003
  16. Lee HS, Ly SY. Nutrient intake status and relevant factors of hemodialysis patients hospitalized in general hospital located in Daejeon. Korean Association of Human Ecology. 2016;25(1):55-71. https://doi.org/10.5934/kjhe.2016.25.1.55
  17. Moorthi RN, Avin KG. Clinical relevance of sarcopenia in chronic kidney disease. Current Opinion in Nephrology and Hypertension. 2017;26(3):219-28. https://doi.org/10.1097/MNH.0000000000000318
  18. Park YJ, Lee HJ. The levels of physical activity and its relationships with depression, health-related quality of life, sleep disturbance, and physiological indicators in hemodialysis patients. Korean Journal of Adult Nursing. 2015;27(6):718-27. https://doi.org/10.7475/kjan.2015.27.6.718
  19. Go SW, Cha YH, Lee JA, Park HS. Association between sarcopenia, bone density, and health-related quality of life in Korean men. Korean Journal of Family Medicine. 2013;34(4):281-8. https://doi.org/10.4082/kjfm.2013.34.4.281
  20. Ren H, Gong D, Jia F, Xu B, Liu Z. Sarcopenia in patients undergoing maintenance hemodialysis: incidence rate, risk factors and its effect on survival risk. Renal Failure. 2016;38(3):364-71. https://doi.org/10.3109/0886022X.2015.1132173
  21. Cruz-Jentoft A, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169
  22. Souza VAd, Oliveira D, Barbosa SR, Correa JOdA, Colugnati FAB, Mansur HN, et al. Sarcopenia in patients with chronic kidney disease not yet on dialysis: analysis of the prevalence and associated factors. Plos One. 2017;12(4):1-13. https://doi.org/10.1371/journal.pone.0176230
  23. Mori K, Nishide K, Okuno S, Shoji T, Emoto M, Tsuda A, et al. Impact of diabetes on sarcopenia and mortality in patients undergoing hemodialysis. BMC Nephrology. 2019;20(1):105. https://doi.org/10.1186/s12882-019-1271-8
  24. Kim JK, Kim SG, Oh JE, Lee YK, Noh JW, Kim HJ, et al. Impact of sarcopenia on long-term mortality and cardiovascular events in patients undergoing hemodialysis. The Korean Journal of Internal Medicine. 2019;34(3):599-607. https://doi.org/10.3904/kjim.2017.083
  25. Cho HM, Yoo EK. The factors influencing the resilience among hemodialysis patients. Korean Journal of Adult Nursing. 2014;26(6):614-20. https://doi.org/10.7475/kjan.2014.26.6.614
  26. Kim YJ, Choi HJ. The influence of uncertainty and social support on general well-being among hemodialysis patients. The Korean Journal of Rehabilitation Nursing. 2012;15(1):20-9. https://doi.org/10.7587/kjrehn.2012.20
  27. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. Journal of the American Medical Directors Association. 2013;14(8):531-2. https://doi.org/10.1016/j.jamda.2013.05.018
  28. Kim S, Kim M, Won CW. Validation of the Korean version of the SARC-F questionnaire to assess sarcopenia: Korean frailty and aging cohort study. Journal of the American Medical Directors Association. 2018;19(1):40-5. https://doi.org/10.1016/j.jamda.2017.07.006
  29. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2001;56(6):M366-72. https://doi.org/10.1093/gerona/56.6.M366
  30. Nestle Nutrition Institute. MNA® Forms [Internet]. Switzerland: Nestle Nutrition Institute; 2021 [cited 2021 February 14]. Available from: https://www.mna-elderly.com/mna-forms
  31. The International Consensus Group for the Development of an International Physical Activity Questionnaire. IPAQ [Internet]. IPAQ; 2019 [cited 2019 July 27]. Available from: https://sites.google.com/site/theipaq/
  32. Jiang K, Slee A, Davenport A. Screening tests for sarcopenia in patients with chronic kidney disease. Nutrition in Clinical Practice. 2021;36(5):1049-52. https://doi.org/10.1002/ncp.10597
  33. Kim HH, Kim JS, Yu JO. Factors contributing to sarcopenia among community-dwelling older Korean adults. Journal of Korean Gerontological Nursing. 2014;16(2):170-9. https://doi.org/10.17079/jkgn.2014.16.2.170
  34. Maltais ML, Desroches J, Dionne IJ. Changes in muscle mass and strength after menopause. Journal of Musculoskeletal & Neuronal Interactions. 2009;9(4):186-97.
  35. Moon SJ, Kim TH, Yoon SY, Chung JH, Hwang HJ. Relationship between stage of chronic kidney disease and sarcopenia in Korean aged 40 years and older using the Korea national health and nutrition examination surveys (KNHANES IV-2, 3, and V-1, 2) 2008-2011. PLoS One. 2015;10(6):1-11. https://doi.org/10.1371/journal.pone.0130740
  36. Wu T, Liaw C, Chen F, Kuo K, Chie W, Yang R. Sarcopenia screened with SARC-F questionnaire is associated with quality of life and 4-year mortality. Journal of the American Medical Directors Association. 2016;17(12):1129-35. https://doi.org/10.1016/j.jamda.2016.07.029
  37. Cho GY, Bae EJ, Kim YH. Association between sarcopenia and health risk behaviors by age groups in Korean adults: Korea national health and nutrition examination survey IV to V. Journal of The Korean Data Analysis Society. 2019;21(3):1523-37. https://doi.org/10.37727/jkdas.2019.21.3.1523
  38. Hong SM, Choi WH. Clinical and physiopathological mechanism of sarcopenia. Korean Journal of Medicine. 2012;83(4):444-54. https://doi.org/10.3904/kjm.2012.83.4.444
  39. Johansen KL, Chertow GM, Kutner NG, Dalrymple LS, Grimes BA, Kaysen GA. Low level of self-reported physical activity in ambulatory patients new to dialysis. Kidney International. 2010;78(11):1164-70. https://doi.org/10.1038/ki.2010.312
  40. Uemura K, Doi T, Lee S, Shimada H. Sarcopenia and low serum albumin level synergistically increase the risk of incident disability in older adults. Journal of the American Medical Directors Association. 2019;20(1):90-3. https://doi.org/10.1016/j.jamda.2018.06.011
  41. Ekramzadeh M, Mazloom Z, Jafari P, Ayatollahi M, Sagheb MM. Major barriers responsible for malnutrition in hemodialysis patients: challenges to optimal nutrition. Nephro-Urology Monthly. 2014;6(6):e23158. https://doi.org/10.5812/numonthly.23158
  42. Leon JB, Majerle AD, Soinski JA, Kushner I, Ohri-Vachaspati P, Sehgal AR. Can a nutrition intervention improve albumin levels among hemodialysis patients? A pilot study. Journal of Renal Nutrition. 2001;11(1):9-15. https://doi.org/10.1016/S1051-2276(01)79890-1