Dialysis vintage is partially associated with sarcopenia in patients on hemodialysis.

IF 2.2 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2025-03-28 DOI:10.1159/000545258

Dario R Mondini, Marvery P Duarte, Maryanne Zilli Canedo Silva, Henrique Santos Disessa, Maristela Bohlke, Angélica N Adamoli, Rodrigo R Krug, Maria C K Panno, Daiana C Bundchen, Luiz A R Medina, Antônio J Inda-Filho, Jacyara Santos de Oliveira, Barbara P Vogt, Maycon M Reboredo, Marco C Uchida, Heitor S Ribeiro

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Abstract

Introduction: Dialysis-related factors may contribute to sarcopenia, but this has yet to be explored. We investigated the association between dialysis vintage and sarcopenia in patients on hemodialysis.

Methods: A cross-sectional analysis of the SARC-HD study. Sarcopenia was assessed according to the revised EWGSOP2 criteria using handgrip strength and calf circumference measurements. We considered sarcopenia as confirmed and severe stages. Patients were stratified into groups according to the quintiles of dialysis vintage months: 3-11; 12-24; 25-43; 44-76; and ≥77. The 12-24 months group was adopted as reference in adjusted binary logistic regressions.

Results: 983 patients from 19 dialysis centers were included (67% male, median age 59 years). The median dialysis vintage was 33 months [interquartile range: 14-67], 31% were receiving hemodiafiltration, and 29% had a short daily weekly frequency (≥4 sessions/week). Probable sarcopenia was found in 12%, confirmed in 9%, and severe in 5%. Probable sarcopenia was higher in the 3-11 months group (p=0.045). In the overall analysis, no significant association was found between dialysis vintage and sarcopenia. However, in sensitivity exploratory analyses excluding patients on hemodiafiltration, the shortest (adjusted odds ratio [aOR] = 2.95, 95% confidence interval [CI]: 1.24-7.00) and longest (OR=3.02, 95%CI: 1.22-7.44) dialysis vintage groups showed higher odds of sarcopenia compared to the 12-24 months group. A similar pseudo-U-shaped association was found among patients on conventional weekly frequency (excluding short daily), where the shortest (aOR=2.88, 95%CI: 1.23-6.74) and longest (aOR=2.77, 95%CI: 1.17-6.55) dialysis vintage groups were associated with higher odds of sarcopenia.

Conclusion: In conclusion, the association between dialysis vintage and sarcopenia was observed in conventional hemodialysis regimens. This association seems to be pseudo-U-shaped in the shortest and longest dialysis vintage groups. Future studies should examine how pre-dialysis care and dialysis regimens affect sarcopenia development or progression.

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透析时间与血液透析患者的肌肉减少症部分相关。

透析相关因素可能导致肌肉减少症，但这还有待探讨。我们调查了透析时间与血液透析患者肌肉减少症之间的关系。方法：对SARC-HD研究进行横断面分析。肌肉减少症根据修订后的EWGSOP2标准进行评估，使用握力和小腿围测量。我们认为肌肉减少症是确诊和严重的阶段。按透析起始月份五分位数分组：3 ~ 11个月；12 - 24;25-43;44 - 76;和≥77。采用调整后的二元logistic回归，以12-24个月组为参照。结果：纳入了来自19个透析中心的983例患者（67%为男性，中位年龄59岁）。中位透析时间为33个月[四分位数范围：14-67]，31%接受血液渗滤，29%每日每周频率较短（≥4次/周）。12%的患者可能出现肌肉减少症，9%的患者确诊，5%的患者严重。3-11个月组肌少症发生率较高（p=0.045）。在整体分析中，没有发现透析时间和肌肉减少症之间的显著关联。然而，在排除血液滤过患者的敏感性探索性分析中，最短（校正优势比[aOR] = 2.95, 95%可信区间[CI]: 1.24-7.00）和最长（OR=3.02, 95%CI: 1.22-7.44）透析时间组与12-24个月组相比，出现肌肉减少症的几率更高。在常规每周透析频率（不包括短每日）的患者中发现了类似的伪u形关联，其中最短（aOR=2.88, 95%CI: 1.23-6.74）和最长（aOR=2.77, 95%CI: 1.17-6.55）的透析年份组与较高的肌少症发生率相关。结论：在常规血液透析方案中，透析时间与肌肉减少症之间存在相关性。在最短和最长的透析年份组中，这种关联似乎呈伪u形。未来的研究应该检查透析前护理和透析方案如何影响肌肉减少症的发展或进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.