DETERMINANT FACTORS OF SARCOPENIA AMONG PRE-DIALYSIS OUTPATIENTS IN A MALAYSIAN TERTIARY CARE CENTRE

Abstract

Sarcopenia is an ageing condition characterised by a progressive and generalised loss of skeletal muscle mass and function. However, sarcopenia is not always related to advanced age in chronic kidney disease (CKD) but rather a consequence of accelerated protein catabolism. This study aimed to identify the prevalence of sarcopenia and its associated risk factors in pre-dialysis CKD patients. This cross-sectional study was conducted among 250 pre-dialysis CKD patients aged 18 years or older who attended the outpatient Renal Clinic in a tertiary hospital between April to November 2019. It was found that 59.2% of pre-dialysis CKD patients had slow gait speed, 52% had low handgrip strength, and 5.2% had low appendicular skeletal muscle mass index. The prevalence of sarcopenia in the studied group based on AWGS criteria was 5.2%, for which CKD stage 3-5 accounts for 0.4%, 0.8%, and 4% of the prevalence, respectively. Body mass index (AOR: 0.39, 95% CI: 0.166-0.912) and Modified Barthel Index score (AOR: 0.64, 95% CI: 0.470-0.884) were significantly associated with sarcopenia.to conclude, sarcopenia is prevalent in advanced-stage CKD and is related to low body mass index and a lack of functional independence. Controlling these two factors may delay sarcopenia progression in CKD patients. Given this, there is an urgent need to develop preventative and therapeutic approaches given the detrimental effects of sarcopenia on significant health outcomes in the CKD population. The effectiveness of dietary and exercise therapies to prevent sarcopenia in CKD should be explored.