الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Sarcopenia, a progressive loss of skeletal muscle mass and strength, is
a prevalent condition among patients with CKD, particularly those
undergoing hemodialysis. Sarcopenia in HD patients is associated with
adverse outcomes, including physical disability, poor quality of life,
increased cardiovascular risk, and higher mortality rates.
This study aimed to evaluate the prevalence and associated factors
contributing to sarcopenia in a cohort of regular HD patients, providing
valuable insights for the development of targeted interventions and strategies
to mitigate the burden of this condition.
This cross-sectional study evaluated factors affecting sarcopenia in 86
regular HD patients. The participants were divided into three groups based
on the presence and severity of sarcopenia according to the EWGSOP2
criteria: group I (without sarcopenia, n=31), group II (pre-sarcopenia,
n=14), and group III (sarcopenia, n=41).
Sarcopenia was defined as the coexistence of low muscle strength,
assessed by handgrip strength, and reduced muscle quantity measured by
mid-arm muscle circumference and BIA. Appendecular Skeletal Muscle
mass index (ASMI) was calculated from BIA data. Additionally, the SGA
score and biochemical parameters were evaluated for each participant
The results demonstrated a high prevalence of sarcopenia among HD
patients with 47.7% of the studied population being diagnosed with
sarcopenia according to the EWGSOP2 criteria.
The results also demonstrated a significant difference was observed in
dialysis vintage with sarcopenic patients having a longer duration of dialysis
secondary to chronic catabolic state, muscle wasting, decreased muscle
endurance, increased oxidative stress and chronic inflammation.
Statistical analysis also identified that DM was significantly higher in
the sarcopenic group. This may be explained by insulin resistance, chronic
inflammation, and impaired protein synthesis.
Anthropometric measurements revealed a lower mean values of dry
body weight and BMI compared to the non-sarcopenic group reflecting a
poor oral intake, malnutrition, and poor nutritional status.
Sarcopenia assessment using ASMI, handgrip strength, and MAC,
revealed lower mean values for all these measures compared to the non
sarcopenic group reflecting the reduced muscle mass and strength associated
with sarcopenia.
Nutritional status assessment using SGA score and serum albumin
showed a higher prevalence of severe malnutrition in the sarcopenic group
compared to the other groups secondary to multiple factors including
insufficient dietary intake and a loss of nutrients through the dialysate, or an
increased muscle breakdown due to inflammation or metabolic acidosis.
Laboratory data analysis revealed significant low levels of
hemoglobin, creatinine and Kt/V in sarcopenic patients indicating that
anemia, low muscle mass and insufficient dialysis are risk factors for
development of sarcopenia in hemodialysis patients.
Laboratory data analysis also revealed significant high levels of
cholesterol, triglycerides, and CRP in sarcopenic patients denoting that
dyslipidemia and inflammation are risk factors for development of
sarcopenia in such group.