Prevalence, Incidence, and Associated Factors of Possible Sarcopenia in Patients Undergoing Maintenance Hemodialysis: A Prospective Cohort Study

OBJECTIVES: Possible sarcopenia refers to low muscle strength with or without reduced physical performance and is considered a sentinel stage of sarcopenia. Few studies have focused on possible sarcopenia in patients undergoing maintenance hemodialysis (MHD). Therefore, this study investigated the prevalence and incidence of possible sarcopenia in patients undergoing MHD and analyzed its associated factors to provide evidence for early identification and intervention in the prevention of sarcopenia. METHODS: This prospective cohort study collected demographic and laboratory parameters, dietary and nutritional status, and physical activity level (PAL) at baseline and 1-year follow-up. Possible sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia 2019 Consensus, with assessments conducted at baseline and 1 year later. A binary logistic regression model was used to identify independent factors associated with the incidence of possible sarcopenia. RESULTS: In total, 346 patients undergoing MHD were included, of whom 293 completed the 1-year follow-up (women, 39.5%; mean age, 53.57 ± 12.43 years). The prevalence of possible sarcopenia at baseline was 50.0% (173 of 346), and the incidence after 1 year was 29.1% (43 of 148). Binary logistic regression analysis showed that possible sarcopenia was independently associated with age (OR = 1.071; 95% confidence interval [CI] = 1.023-1.122; P = .004), Modified Quantitative Subjective Global Assessment score (OR = 1.336; 95% CI = 1.020-1.749; P = .035), PAL (OR = 0.208; 95% CI = 0.071-0.605; P = .004), and phase angle (OR = 0.432; 95% CI = 0.241-0.775; P = .005). CONCLUSIONS: The prevalence and incidence of possible sarcopenia are high among patients undergoing MHD. Older age, higher Modified Quantitative Subjective Global Assessment score, lower PAL, and lower phase angle were associated with an increased risk of possible sarcopenia.