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The influencing factors and prognosis of sarcopenia in maintenance hemodialysis patients

  • ZHONG Zhi-Cong ,
  • WU Yi-Fan ,
  • WEI Lin
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  • School of Nursing, Hunan University of Traditional Chinese Medicine, Changsha 410208, China; 2National Key Laboratory of Traditional Chinese Medicine Syndrome, Nursing Department, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China

Received date: 2023-10-18

  Revised date: 2024-01-08

  Online published: 2024-04-12

Abstract

Objective  To investigate the prevalence, risk factors and survival prognosis of sarcopenia in maintenance hemodialysis(MHD)patients.  Methods  A total of 177 MHD patients from December 2021 to August 2023 were selected as the study objects by convenience sampling method. The incidence of sarcopenia was analyzed, and univariate and multivariate logistic regression analyses were performed to explore the independent influencing factors for sarcopenia. Kaplan-Meier curve was used to analyze the 12-month survival prognosis of MHD patients with and without sarcopenia.   Results   ①In the 177 MHD patients, sarcopenia was found in 65 patients(36.72%) and was not found in 112 patients(63.28%). ②Multivariate logistic regression showed that age (OR=1.078,95% CI:1.030~1.143,P=0.002),dialysis months (OR=1.019, 95% CI:1.008~1.030,P=0.001),diabetes mellitus(OR=4.802,95% CI:1.484~15.603,P=0.009), lower level of physical activity (OR=4.222,95% CI:1.013~17.653,P=0.048) were the independent factors for sarcopenia. ③After 12 months of follow-up, the survival rate of MHD patients with sarcopenia was 69.23% (45/65), and that of the patients without sarcopenia was 89.29% (100/112). Kaplan-Meier survival analysis found that the overall survival rate of non-sarcopenia group was significantly higher than that of sarcopenia group (log-rank test,χ2=11.272,P<0.001). There was no significant difference in overall survival rate between appendicular skeletal muscle mass index (ASMI) compliant group and non-compliant group (log-rank test, χ2=2.374, P=0.123). The overall survival rate of grip strength compliant group was significantly higher than that of grip strength non-compliant group (log-rank test, χ2=10.086, P=0.001). The overall survival rate in the 5-time sitting-standing test compliant group was significantly higher than that in the non-compliant group (log-rank test, χ2=19.668,P<0.001).   Conclusion   The prevalence of sarcopenia is higher in MHD patients, and the survival rate in the follow-up period of 12 months is low in in MHD patients with sarcopenia. Medical staff should make early diagnosis of sarcopenia in MHD patients and take effective intervention measures to improve their prognosis.

Cite this article

ZHONG Zhi-Cong , WU Yi-Fan , WEI Lin . The influencing factors and prognosis of sarcopenia in maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2024 , 23(04) : 307 -312 . DOI: 10.3969/j.issn.1671-4091.2024.04.015

References

[1]Wang L,Xu X,Zhang M,et al.Prevalence of Chronic Kidney Disease in China:Results From the Sixth China Chronic Disease and Risk Factor Surveillance[J].JAMA Intern Med, 2023, 183:298-310 [2]姜珊, 康琳, 刘晓红.亚洲肌少症诊断及治疗共识解读[J].中华老年医学杂志, 2020, 39(4):373-376 [3]Chen LK, Woo J, Assantachai P,et al.Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment[J].J Am Med Dir Assoc, 2020, 21:300-307 [4]Dong ZJ, Zhang HL, Yin LX.Effects of intradialytic resistance exercise on systemic inflammation in maintenance hemodialysis patients with sarcopenia: a randomized controlled trial[J].Int Urol Nephrol, [J].Int Urol Nephrol, 2019, 51(8):1415-1424 [5]陈香美.[J].血液净化标准操作规程, 2021, :190-192 [6]陈香美.血液净化标准操作规程[M].人民卫生出版社, 2021:190-192. [7]黄家晟.国际体力活动问卷在慢性肾脏病人群的信度效度及中医证候研究[D].广州中医药大学, 2019. [8]樊萌语, 吕筠, 何平平.国际体力活动问卷中体力活动水平的计算方法[J].中华流行病学杂志, 2014, 35(8):961-964 [9]梁丹华, 谭荣韶, 刘岩, 等.三种营养筛查工具对维持性血液透析病人透析相关性蛋白质-能量消耗的评价比较[J].肠外与肠内营养, 2017, (3):138-142 [10]张世鑫.专家解读版亚洲肌少症诊断及治疗共识[J].中华医学信息导报, 2020, 35(11):12-12 [11]Cruz-Jentoft AJ, Bahat G, Bauer J,et al.Sarcopenia: revised European consensus on definition and diagnosis[J].Age Ageing, 2019, 48(4):601-601 [12]Noce A, Marrone G, Ottaviani E, et al.Uremic Sarcopenia and Its Possible Nutritional Approach[J].Nutrients, 2021, 13(1):7- [13]Mauren M, Vanessa LP, Thaiciane G, et al.Difference in sarcopenia prevalence and associated factors according to 2010 and 2018 European consensus ( EWGSOP ) in elderly patients with type 2 diabetes mellitus[J].Exp Gerontol, 2020, 132:1108-1135 [14]崔华,王朝晖,吴剑卿, 等.老年人肌少症防控干预中国专家共识[J].中华老年医学杂志, 2023, 42(02):144-153 [15]Ren H, Gong D, Jia F, et al.Sarcopenia in patients undergoing maintenance hemodialysis: incidence rate,risk factors and its effect on survival risk[J].Ren Fail, 2016, 38(3):364-71 [16]蔡琪, 池向耿, 许敏玲.维持性血液透析患者骨骼肌减少症及影响因素分析[J].中国血液净化, 2019, 18(9):626-629 [17]王凯选, 于鹏飞, 刘志梅等.维持性血液透析病人肌少症发生现状及影响因素研究[J].护理研究, 2022, 36(07):1270-1275 [18]其李玉琢,李嘉琪,刘云, 等.肌少症对维持性血液透析患者生存预后的影响[J].中华肾脏病杂志, 2023, 39(05):337-344 [19]郑媛媛, 周道远, 刘岩等.低握力是维持性血液透析患者感染性疾病住院的危险因素[J].暨南大学学报自然科学与医学版, 2022, 43(04):406-411 [20]王楠, 魏雅楠, 刘杰, 等.住院老年慢性病患者肌少症的相关影响因素分析[J].中国全科医学, 2020, 23(5):611-616 [21]Kim JK, Choi SR, Choi MJ et al.Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease[J].Clin Nutr, 2014, 33:64-68 [22]董志娟, 张海林.维持性血液透析患者肌少症发生的危险因素分析[J].护理学杂志, 2018, 33(9):20-24 [23]张琦, 秦海峰, 简桂花,等.老年血液透析患者肌少症临床特点及危险因素分析[J].中华老年医学杂志, 2020, 39(9):1046-1049 [24]Mori K, Nishide K, Okuno S, et al.Impact of diabetes on sarcopenia and mortality in patients undergoing hemodialysis[J].BMC Nephrol, 2019, 20(1):105- [25]何清华,孙明晓,岳燕芬, 等.北京地区中老年型糖尿病患者肌少症患病率研究及影响因素分析[J].中华糖尿病杂志, 2019, 11(5):328-333 [26]刘丹, 张红梅, 范汝艳, 等.维持性血液透析患者肌肉减少症调查及影响因素分析[J].中国中西医结合肾病杂志, 2018, 19(4):329-332 [27]Howden EJ, Coombes JS, Strand H,et al.Exercise training in CKD: efficacy, adherence, and safety.[J].Am J Kidney Dis, 2015, 65:583-591 [28]Kortebein P, Ferrando A, Lombeida J, et al.Effect of 10 days of bed rest on skeletal muscle in healthy older adults[J].JAMA, 2007, 297(16):1772-4 [29]吴庆峰, 李珍, 常立阳等.运动疗法与营养干预对血液透析肌少症患者影响的分析[J].护理与康复, 2023, 22(05):24-30 [30]Moriyama Y, Hara M, Aratani S,et al.The association between six month intra-dialytic resistance training and muscle strength or physical performance in patients with maintenance hemodialysis: a multicenter retrospective observational study.[J].BMC Nephrol, 2019, 20:172-
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