Prevalência e fatores associados com a coexistência de desnutrição e sarcopenia em pacientes em hemodiálise: resultados do estudo SARC-HD

Abstract

Background: Metabolic and nutritional changes may predispose to the occurrence of sarcopenia and malnutrition in patients with chronic kidney disease. Therefore, this study evaluated the prevalence and factors associated with the coexistence of sarcopenia and malnutrition in patients on hemodialysis. Methods: This cross-sectional study was an exploratory analysis of the multicenter SARC-HD (SARCopenia trajectories and associations with clinical outcomes in patients on HemoDialysis) study that included 19 dialysis units across Brazil. Patients were submitted to the following evaluations: muscle strength (handgrip strength), muscle mass (calf circumference), physical performance (gait speed 4-m test), and physical activity levels (International Physical Activity Questionnaire - Short Form). The diagnosis of sarcopenia and malnutrition were based on the revised European Working Group on Sarcopenia in Older People and the Global Leadership Initiative on Malnutrition, respectively. Results: This study included 903 patients (median 59 years, 60.9% male, and median 32 months on treatment). The prevalence of sarcopenia was 15.4% and malnutrition was 35.7%, and 12.3% of patients presented sarcopenia and malnutrition. The coexistence of sarcopenia and malnutrition was higher in older compared to younger patients (73.9% vs. 26.1%, p < 0.05). The multinomial logistic regression showed that male sex (OR: 1.97; 95% CI: 1.18 to 3.27), creatinine (OR: 0.82; 95% CI: 0.73 to 0.92) and ferritin levels (OR: 1.01; 95% CI: 1.00 to 1.02), and gait speed (OR: 0.22; 95% CI: 0.09 to 0.52) were significantly associated with coexistence of sarcopenia and malnutrition. Conclusion: The prevalence of the coexistence of sarcopenia and malnutrition in patients on hemodialysis was 12.3%, and the factors associated with these conditions were male sex, levels of creatinine and ferritin and physical performance.