Nutritional Status Association With Sarcopenia in Patients Undergoing Maintenance Hemodialysis Assessed by Nutritional Risk Index

Kurajoh, Masafumi; Mori, Katsuhito; Miyabe, Mizuki; Matsufuji, Shota; Ichii, Mitsuru; Morioka, Tomoaki; Kizu, Akane; Tsujimoto, Yoshihiro; Emoto, Masanori

doi:10.3389/fnut.2022.896427

Cited by 15 publications

(7 citation statements)

References 48 publications

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“…In addition to age-related processes, sarcopenia in potential KT recipients is also worsened by various factors, including malnutrition, metabolic acidosis, accumulation of uremic toxins, and amino acid loss during dialysis, as well as typical low-threshold inflammation [34]. Malnutrition is very common in patients requiring dialysis and leads to sarcopenia in these patients by reducing muscle mass and strength as well as physical performance [35]. Furthermore, dialysis patients have a lower physical activity compared to healthy people of the same age, which in turn increases muscle wasting [36].…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Karakizlis

Trudel

Brose

et al. 2023

Langenbecks Arch Surg

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Purpose The association between sarcopenia of kidney transplant recipients and outcome after kidney transplantation (KT) has not yet been fully understood and is still considered controversial. The aim of our study was to analyze the impact of pre-transplant sarcopenia on graft function, postoperative complication rates, and survival of the patients after renal transplantation. Methods In this retrospective single-center study, all patients who underwent KT (01/2013–12/2017) were included. Demographic data, rejection rates, delayed graft function, and graft and patient survival rates were analyzed. Sarcopenia was measured in computed tomography images by the sex-adjusted Hounsfield unit average calculation (HUAC). Results During the study period, 111 single KTs (38 women and 73 men) were performed. Living donor kidney transplants were performed in 48.6%. In total, 32.4% patients had sarcopenia. Sarcopenic patients were significantly older (59.6 years vs. 49.8 years; p < 0.001), had a higher body mass index (BMI = 27.6 kg/m2 vs. 25.0 kg/m2; p = 0.002), and were more likely to receive deceased donor kidneys (72.2% vs. 41.3%; p = 0.002). Interestingly, 3 years after KT, the creatinine serum levels were significantly higher (2.0 mg/dl vs. 1.5 mg/dl; p = 0.001), whereas eGFR (39.9 ml/min vs. 53.4 ml/min; p = 0.001) and graft survival were significantly lower (p = 0.004) in sarcopenic transplant recipients. Sarcopenic patients stayed in hospital significantly longer postoperatively than those who were non-sarcopenic. Conclusions At the time of kidney transplantation, sarcopenia was found to predict reduced long-term graft function and diminished graft survival after KT. The early identification of sarcopenic patients can not only enable an optimized selection of recipients, but also the initiation of pre-habilitation programs during the waiting period.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Karakizlis

Trudel

Brose

et al. 2023

Langenbecks Arch Surg

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“…The new index included only four objective indicators, namely BMI, serum albumin, and total cholesterol and creatinine levels [ 51 ]. Subsequent studies have confirmed [ 24 , 52 ] that NRI-JH is a useful tool for assessing the nutritional status of dialysis patients and that its score is significantly associated with sarcopenia in dialysis patients.…”

Section: Related Index Of Malnutrition In Dialysis Patientsmentioning

confidence: 97%

Progress in the study of nutritional status and selenium in dialysis patients

et al. 2023

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Malnutrition is very common in patients with chronic kidney disease, especially in those on maintenance dialysis. Malnutrition is one of the major factors affecting survival and death of dialysis patients, and reducing their activity tolerance and immunity. There are numerous and interacting risk factors for malnutrition, such as reduced nutritional intake, increased energy expenditure, hormonal disorders, and inflammation. Selenium, in the form of selenoproteins, is involved in many physiological processes in the body and plays an important role in maintaining redox homeostasis. Oxidative stress and infection are very common in dialysis patients, and selenium levels in dialysis patients are significantly lower than those in the healthy population. It has been shown that there is a correlation between selenium levels in hemodialysis patients and their nutrition-related indicators, and that selenium supplementation may improve malnutrition in patients. However, further studies are needed to support this conclusion and there is a lack of basic research to further characterize the potential mechanisms by which selenium may improve malnutrition in dialysis patients. The purpose of this review is to provide a comprehensive overview of factors associated with malnutrition in dialysis patients and to describe the progress of research on nutritional status and selenium levels in dialysis patients.

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“…Good nutrition has been shown to be protective against sarcopenia [39]. Hemodialysis patients often experience Protein-energy wasting (PEW), a state of disordered catabolism resulting from metabolic and nutritional derangements in chronic disease states [40].…”

Section: Malnutrition Assessmentmentioning

confidence: 99%

The Role of Medication Literacy and Polypharmacy in Sarcopenia Among Maintenance Hemodialysis Patients: A Cross-Sectional Analysis

Zhu,

Liu,

Yang

et al. 2024

Preprint

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Purpose Sarcopenia is significantly prevalent among maintenance hemodialysis patients, with the contributing factors of medication literacy and polypharmacy receiving limited exploration in current research. This study aims to fill this gap by assessing the impact of these factors, along with demographic and malnurtition, on sarcopenia risk. Methods Conducted at the Wenjiang Hemodialysis Center in West China Hospital, this descriptive cross-sectional study involved 236 participants. Data collection included the Chinese Medication Literacy Scale, Malnutrition-Inflammation Score assessments, bioelectrical impedance analysis, and grip strength measurements, with sarcopenia diagnosed according to the 2019 AWGS criteria. Results The study included 236 participants. Of these, 87 (36.9%) had no sarcopenia, 121 (51.3%) were pre-sarcopenia, 7 (3.0%) were sarcopenia, and 21 (8.9%) had severe sarcopenia. Ordinal logistic regression analysis identified male gender (OR = 0.557, 95% CI: 0.322 to 0.962, P = 0.036), age below 65 (OR = 0.178, 95% CI: 0.082 to 0.389, P < 0.001), and good nutritional status (OR = 0.544, 95% CI: 0.310 to 0.954, P = 0.034) as protective against severe sarcopenia. Conversely, the combination of polypharmacy and limited medication literacy (OR = 1.956, 95% CI: 1.094 to 3.496, P = 0.024) was significantly associated with an increased risk of sarcopenia progression. Conclusion The study highlights the protective role of good nutrition and the lesser susceptibility of males and younger individuals to severe sarcopenia. It underscores the necessity of targeted interventions to address the compounded risk presented by polypharmacy and limited medication literacy in patients undergoing hemodialysis.

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Nutritional Status Association With Sarcopenia in Patients Undergoing Maintenance Hemodialysis Assessed by Nutritional Risk Index

Cited by 15 publications

References 48 publications

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Progress in the study of nutritional status and selenium in dialysis patients

The Role of Medication Literacy and Polypharmacy in Sarcopenia Among Maintenance Hemodialysis Patients: A Cross-Sectional Analysis

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