Prevalence and risk factors of sarcopenia in peritoneal dialysis patients

Abstract

Objective To investigate the prevalence and risk factors of sarcopenia in peritoneal dialysis (PD) patients. Methods The patients who underwent regular peritoneal dialysis at Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine between November 2016 and March 2018 were enrolled. Handgrip strength (HGS) was measured to assess muscle strength. Bioelectrical impedance spectroscopy (BIS) was applied to measure the lean tissue index (LTI). Reduced LTI plus decreased HGS was defined as sarcopenia. The prevalence of sarcopenia in PD patients was evaluated. According to the presence or absence of sarcopenia, they were divided into the sarcopenia group and the non-sarcopenia group, and the differences in clinical indicators between the two groups were compared. Multivariate logistic regression was used to explore the risk factors of sarcopenia in PD patients. Results A total of 207 patients were enrolled in the study with age of (55.3±13.7) years and a median PD duration of 22.9(7.3, 60.9) months. Of them, 122 patients (58.9%) were male, 45 patients (21.7%) had diabetics and 32 patients (15.5%) suffered from cardiovascular diseases. There were 27 patients (13.0%) diagnosed with sarcopenia. These patients presented with longer PD duration, more prevalent diabetics, lower residual renal function (RRF) and serum pre-albumin, greater ratio of extracellular water to intracellular water (ECW/ICW) and high sensitive C-reactive protein in contrast with those in the non-sarcopenia group (all P<0.05). Multivariate logistic analysis showed that male (OR=3.94, 95%CI 1.35-11.50, P=0.012), longer PD duration (OR=1.01, 95% CI 1.00-1.02, P=0.029) and higher ECW/ICW (OR=1.09, 95% CI 1.05-1.14, P<0.001) were independent risk factors of sarcopenia in PD patients. Conclusions Sarcopenia is common in PD patients. Male, longer PD duration and higher ECW/ICW were independent risk factors of sarcopenia in PD patients. Key words: Peritoneal dialysis; Prevalence; Risk factors; Sarcopenia