Abstract
Sarcopenia is common in patients undergoing chronic hemodialysis, which leads to poor outcomes. SARC-F (sluggishness, assistance in walking, rising from a chair, climb stairs, falls), a self-report questionnaire, is recommended as an easily applied tool for screening sarcopenia in older people. However, there are limited data regarding its use in patients undergoing chronic hemodialysis. Therefore, we aimed to evaluate the association between SARC-F and mortality in these patients. SARC-F questionnaire was applied in 271 hemodialysis patients (mean age 64.4 ± 14.3 years) at baseline. The association between SARC-F and mortality during a 24-month follow-up was analyzed. During this follow-up period, 40 patients (14.8%) died. The discriminative power of SARC-F score for predicting mortality was 0.716 (95% confidence interval (CI) = 0.659–0.769; p < 0.001). The best cut-off was a score ≥1, which provided 85.0% sensitivity, 47.2% specificity, 21.8% positive predictive value, and 94.8% negative predictive value. Kaplan–Meier curves showed that patients with SARC-F ≥ 1 exhibited a higher risk of mortality than those with SARC-F < 1 (p < 0.001). Moreover, a stepwise decline in survival with higher SARC-F scores was also observed. After full adjustments, SARC-F ≥ 1 was independently associated with increased mortality (hazard ratio = 2.87, 95% CI = 1.11–7.38; p = 0.029). In conclusion, SARC-F applied for sarcopenia screening predicted mortality in patients undergoing chronic hemodialysis.
Highlights
Sarcopenia is characterized by the progressive loss of skeletal muscle mass, strength, and physical performance during the aging process and leads to poor clinical outcomes in the geriatric population [1,2,3].The prevalence of sarcopenia is considerably higher in patients with end-stage renal disease (ESRD)compared to the general population [4,5,6]
The best cut-off for predicting sarcopenia was a score ≥1, which provided body composition, SARC-F scores were only negatively correlated with muscular circumference (MAMC) (r = −0.253, p = 0.011)
We found that patients who had SARC-F ≥ 1 were associated with an increase of 2-year mortality in both crude and adjusted Cox models
Summary
Sarcopenia is characterized by the progressive loss of skeletal muscle mass, strength, and physical performance during the aging process and leads to poor clinical outcomes in the geriatric population [1,2,3].The prevalence of sarcopenia is considerably higher in patients with end-stage renal disease (ESRD)compared to the general population [4,5,6]. Sarcopenia is characterized by the progressive loss of skeletal muscle mass, strength, and physical performance during the aging process and leads to poor clinical outcomes in the geriatric population [1,2,3]. Dual-energy X-ray absorptiometry, computed tomography, bioelectrical impedance analysis (BIA), and dynamometer readings are among the recommended techniques for measurement of skeletal muscle mass and strength in the clinical setting [10]. Some of these are not widely applicable. There is no consensus as to the optimal screening tool for the early detection of sarcopenia in patients undergoing hemodialysis (HD)
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