Association of sarcopenia and its components with clinical outcomes in patients undergoing peritoneal dialysis

Abstract

Background Further studies are needed to identify whether muscle mass, muscle strength, or sarcopenia is the best indicator of survival in patients undergoing peritoneal dialysis (PD). We aimed to compare the association of sarcopenia and its components with survival in patients undergoing PD. Methods We identified all patients with PD (n = 199). We routinely recommended handgrip strength (HGS) and lean mass measurements using dual energy X-ray absorptiometry in all patients with PD. Sarcopenia was defined using cutoff values from the Asian Working Group for Sarcopenia. We evaluated the patient and technique survival rates. Results The number of patients with low HGS was 95 (47.7%). The median follow-up interval was 17 months (interquartile range, 13–21 months). Kaplan-Meier curve analysis showed that patients with low HGS or sarcopenia had poorer patient and technique survival compared with patients with normal HGS or without sarcopenia. Cox regression analysis showed that patients with low HGS had greater hazard ratios for patient death and technique failure compared with those with normal HGS. However, patients with low muscle mass were not significantly higher hazard ratios for patient death or technique failure compared with those with normal muscle mass. Patients with sarcopenia had significantly greater hazard ratios for patient death or technique failure than those without sarcopenia only in univariate analysis. Conclusion The present study demonstrated that HGS may be superior to muscle mass or sarcopenia for predicting patient or technique survival in patients undergoing PD.

Keywords

• hand strength
• muscle
• peritoneal dialysis
• sarcopenia
• survival