Prevalence and Predictors of Sarcopenia, Protein-Energy Wasting, and Sarcopenic Obesity in Patients with Chronic Kidney Disease

Abstract

Background Sarcopenia, sarcopenic obesity, and protein-energy wasting (PEW) are common in patients with chronic kidney disease (CKD) and are associated with adverse outcomes. This study is aimed at determining their prevalence and predictors. Materials and Methods This cross-sectional study included 442 adult CKD patients. Sarcopenia was defined using a modified Asian Working Group for Sarcopenia criteria, sarcopenic obesity as the coexistence of sarcopenia and obesity, and PEW according to the International Society of Renal Nutrition and Metabolism criteria. Results Sarcopenia prevalence was 29.9% (132 patients), with 9.5% being severe, 12.7% moderate, and 7.7% mild. Sarcopenic obesity affected 13.3% (59 patients) and PEW was noted in 27.3% (121 patients). Among sarcopenic patients, 59% met PEW criteria. Multivariate analysis identified increasing age, male sex, higher body mass index BMI, lower estimated glomerular filtration rate (eGFR), and cardiovascular disease as independent predictors of sarcopenia. Higher BMI, lower eGFR, and cardiovascular disease predicted sarcopenic obesity. For PEW, significant predictors included age, lower BMI, decreased eGFR, advanced CKD stage, cardiovascular disease, and sarcopenia. Conclusion Sarcopenia, sarcopenic obesity, and PEW are highly prevalent in CKD patients, with substantial overlap. Advanced age, lower kidney function, and cardiovascular disease are significant predictors across all three conditions. These findings highlight the need for comprehensive nutritional assessment and targeted interventions in CKD patients.