Prevalence and Risk Factors of Sarcopenia in People Receiving Dialysis: A Systematic Review and Meta-Analysis.

Abstract

Background: People receiving dialysis treatment are at higher risk of sarcopenia. This review aimed to determine the global prevalence of sarcopenia in people on peritoneal dialysis and hemodialysis. We investigated whether the prevalence of sarcopenia differs based on assessment criteria, timing of assessment, and measurement tools used and explored the risk factors for sarcopenia in people on dialysis.

Methods: This review followed JBI and PRISMA guidelines and included studies assessing sarcopenia in adults aged 18 and older with chronic kidney disease undergoing dialysis. Five databases were searched from inception to November 2022. The JBI SUMARI software was used to perform the meta-analysis. Publication bias and risk factor analysis were performed using STATA (Version 18).

Results: A meta-analysis of 62 studies (15,382 participants) found the global prevalence of sarcopenia to be 30.1% (95% CI: 25.6%-39.9%) for hemodialysis and 20.5% (95% CI: 15.1%-26.4%) for peritoneal dialysis. Sarcopenia prevalence ranged between 23.1% and 30.3% in HD and between 6.1% and 26.9% in PD, based on the assessment criteria. Post-dialysis sarcopenia prevalence was higher (33%) than pre-dialysis (24.2%) in hemodialysis patients. Measuring muscle mass after dialysis using dual-energy X-ray assessment yielded a lower prevalence of sarcopenia (22.5%) than bioimpedance analysis or spectroscopy (33%). Risk factors in the HD population included age, sex, diabetes, inflammation markers, nutritional indices, and dialysis vintage, although heterogeneity between studies was high.

Conclusion: This study showed a high prevalence of sarcopenia among the dialysis population and identified many risk factors, emphasizing the need for early identification and intervention and standardized assessments.