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Abstract: FR-PO806

Prevalence and Risk Factors of Sarcopenia in ESRD Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Almeida, Alan F., PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  • Bijapur, Kiran, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  • Sirsat, Rasika, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  • Dey, Ayan Kumar, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
  • Prasad, Khairwar Mahesh, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
Background

Sarcopenia is a progressive skeletal muscle disorder involving the accelerated loss of muscle mass and strength, associated with increased adverse outcomes like falls, poor quality of life, frailty, and mortality. Prevalence of sarcopenia in the dialysis population varies from 4% to 63%. However, the prevalence and risk factors in the Indian dialysis population remains uncertain.

Methods

The aim was to study the prevalence of sarcopenia, to identify associated risk factors and to assess the effect of dietary counselling on sarcopenia. It was a prospective observational study, in which, 70 adult patients on maintenance hemodialysis were enrolled and monitored for 6 months. All patients were given dietary counselling at baseline,1,3 and 6 months. Bio-impedance spectroscopy, a hand grip dynamometer, and a 4-meter walk test were employed to evaluate muscle mass, strength, and function, respectively. Asian Working Group for Sarcopenia criteria were used for defining sarcopenia. Univariate and multivariate analysis was done for the factors affecting sarcopenia.

Results

Seventy dialysis patients were evaluated. Age of the cohort was 55.3 ± 13.74 years old. The prevalence of probable sarcopenia, sarcopenia, and severe sarcopenia was 11.43%, 25.71%, and 7.1% respectively. Increasing age and diabetes were potential risk factors for sarcopenia (p < 0.0001 and P< 0.0093 respectively). Sarcopenia was associated with lower BMI (p=0.0006), and lower normalised protein catabolic rate nPCR (p=0.026). Hemoglobin, albumin, calcium, phosphorus, and high sensitivity C reactive protein (hsCRP) did not show any association with sarcopenia. Prevalence of sarcopenia at the end of 6 months was reduced to 17.46% from 25.71%. There was a significant improvement in hand grip strength. nPCR at 6 months was significantly increased in all patients as compared to baseline (p<0.05) which implies improvement in protein consumption.

Conclusion

High prevalence of sarcopenia in dialysis patients in this study emphasizes the importance of increasing clinical awareness about sarcopenia and nutritional status assessment in this group of patients. Several variables like age, BMI, diabetes mellitus and nPCR were significantly associated with sarcopenia. Detailed dietary recall and nutritional intervention can improve sarcopenia and must be actively pursued.