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Prevalence of sarcopenia in elderly maintenance hemodialysis patients: The impact of different diagnostic criteria

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The journal of nutrition, health & aging

Abstract

The prevalence of sarcopenia on elderly maintenance hemodialysis (MHD) has been scarcely investigated.

Objectives

To investigate the prevalence of decreased muscle mass and strength alone or combined (true sarcopenia) in elderly patients on MHD according to different methods and cutoff limits. Additionally, we evaluated the agreement between dual energy x-ray absorptiometry (DXA) and surrogate methods for the assessment of muscle mass.

Design

Observational and cross-sectional study.

Participants

Non-institutionalized 102 elderly (age > 60 years) patients on MHD.

Measurements

Sarcopenia was considered when the patient fit one criteria for low muscle mass assessed by DXA, bioelectrical impedance (BIA), sum of skinfold thicknesses (SKF), calf circumference and mid-arm muscle circumference (MAMC) and one for low muscle strength evaluated by handgrip dynamometer.

Results

Decreased muscle strength was found in 85% of the patients. The prevalence of decreased muscle mass varied from 4 to 73.5% and of sarcopenia (decreased muscle mass and strength combined) from 4 to 63%, depending on the method and cutoff limit applied. A small percentage of patients (2 to 15%) were classified as sarcopenic by more than one diagnostic criteria. The agreement between DXA and the surrogate methods to assess muscle mass showed better kappa coefficients with BIA (r=0.36; P<0.01) and SKF (r=0.40; P<0.01).

Conclusion

A wide prevalence of sarcopenia is observed depending on the method and cutoff limit applied. This may limit extrapolate on to clinical practice. BIA and SKF were the surrogate methods to assess muscle mass with the best concordance with DXA in elderly MHD patients.

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Authors and Affiliations

  1. Post-Graduate program in Food, Nutrition and Health, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil

    F. Lamarca, J. C. D. Rodrigues, F. G. Bigogno, R. L. Fetter & Carla Maria Avesani

  2. Division of Renal Medicine, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

    J. J. Carrero

  3. Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rua São Francisco Xavier, 524. Sala 12025 D. 12° andar, Rio de Janeiro, RJ, Brazil

    Carla Maria Avesani

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  1. F. Lamarca
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Correspondence to Carla Maria Avesani.

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Lamarca, F., Carrero, J.J., Rodrigues, J.C.D. et al. Prevalence of sarcopenia in elderly maintenance hemodialysis patients: The impact of different diagnostic criteria. J Nutr Health Aging 18, 710–717 (2014). https://doi.org/10.1007/s12603-014-0505-5

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  • DOI: https://doi.org/10.1007/s12603-014-0505-5

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