Objective To analyze the risk factors for sarcopenia in patients with maintenance hemodialysis (MHD), so as to explore the preventive measures and the basis for reducing the incidence of sarcopenia in MHD patients. Methods A total of 312 MHD patients admitted to the Sixth People's Hospital Affiliated to Shanghai Jiaotong University from December 2020 to September 2023 were included in this study. According to the presence and absence of sarcopenia, they were divided into the concurrent group (82 cases) and the non-concurrent group (230 cases). Univariate and multivariate logistic regression analyses were used to screen the risk factors for sarcopenia in MHD patients. Results Univariate and multivariate logistic analyses showed that age ≥65 years (OR=1.998, 95% CI: 1.188~3.358, P=0.009), body mass index (BMI) <21 kg/m2 (OR=1.870, 95% CI: 1.037~3.374, P=0.038), glomerular filtration rate <1 mL/min (OR=2.036, 95% CI: 1.120~3.702, P=0.020), higher total body moisture (OR=1.881, 95% CI: 1.013~3.495, P=0.046), higher serum high sensitivity C-reactive protein (hs-CRP) level (OR=1.802, 95% CI: 1.013~3.495, P=0.031), low grip strength (OR=1.749, 95% CI: 1.082~2.827, P=0.023) and low skeletal muscle mass index (ASMI) (OR=1.944, 95% CI: 1.271~2.977, P=0.002) were the risk factors for sarcopenia in MHD patients. Conclusion There are many risk factors for sarcopenia in MHD patients. Clinically, the incidence of sarcopenia in MHD patients can be reduced by prevention and detection of the risk factors.
TENG Yan-Juan
,
YANG Li-Na
,
WANG Nian-Song
,
GUO Yong-Ping
. Analysis of the risk factors for sarcopenia in maintenance hemodialysis patients based on the bioelectrical impedance principle[J]. Chinese Journal of Blood Purification, 2025
, 24(07)
: 609
-613
.
DOI: 10.3969/j.issn.1671-4091.2025.07.014
[1]Duarte M P, Pereira M S, Bai?o V M, et al. Design and methodology of the SARCopenia trajectories and associations with adverse clinical outcomes in patients on HemoDialysis: the SARC-HD study[J]. BMC Nephrol, 2023, 24(1): 239-239.
[2]Reis J M S, Alves L S, Vogt B P. According to revised EWGSOP sarcopenia consensus cut-off points, low physical function is associated with nutritional status and quality of life in maintenance hemodialysis patients[J]. J Ren Nutr, 2022, 32(4): 469-475.
[3]Sanayama H, Ito K, Ookawara S, et al. Positive correlation between relative concentration of spermine to spermidine in whole blood and skeletal muscle mass index: A possible indicator of sarcopenia and prognosis of hemodialysis patients[J]. Biomedicines, 2023, 11(3): 746-746.
[4]秦姣, 刘文霞, 苏佳欣, 等. 维持性血液透析患者肌少症及肌少性肥胖的相关因素[J]. 肾脏病与透析肾移植杂志, 2021, 30(2): 113-118.
[5]杜雯, 陈孜瑾, 王雪洁, 等. 维持性血液透析患者肌少症的患病率及相关影响因素[J]. 中华肾脏病杂志, 2021, 37(5): 407-413.
[6]刘勇, 周加军, 高潮清. 肌少症在维持性血液透析患者中的发生率及其相关危险因素分析[J]. 皖南医学院学报, 2022, 41(1): 25-27, 35.
[7]秦红菊, 倪燕丹, 张小梅, 等. 维持性血液透析患者肌少症发生风险预测模型的构建[J]. 现代临床护理, 2023, 22(6): 15-21.
[8]美国改善全球肾脏病预后组织. KDIGO慢性肾脏病评价及管理临床实践指南[M]. 北京: 人民卫生出版社, 2014: 156-157.
[9]中华医学会骨质疏松和骨矿盐疾病分会. 肌少症共识[J]. 中华骨质疏松和骨矿盐疾病杂志, 2016, 9(3): 215-227.
[10]吴一帆, 何丽换, 傅立哲, 等. 主观综合营养评估法在慢性肾脏病患者中的运用[J]. 广东医学, 2012, 33(13): 1892-1895.
[11]Kono K, Moriyama Y, Yabe H, et al. Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study[J]. BMC Nephrol, 2021, 22(1): 378-378.
[12]Beberashvili I, Azar A, Khatib A, et al. Sarcopenic obesity versus nonobese sarcopenia in hemodialysis patients: differences in nutritional status, quality of life, and clinical outcomes[J]. J Ren Nutr, 2023, 33(1): 147-156.
[13]罗楠, 李新伦, 陈凤锟, 等. 维持性血液透析相关肌肉减少症的患病率及危险因素的横断面调查[J]. 中国血液净化, 2021, 20(8): 536-539, 545.
[14]杨德玉, 王倩毅. 维持性血液透析患者肌少症发生的危险因素及对人体成分分析相关指标的影响[J]. 山西医药杂志, 2020, 49(19): 56-58.
[15]丁妍, 常立阳, 张红梅. 维持性血液透析病人肌少症发生风险预测模型的构建与验证[J]. 护理研究, 2022, 36(20): 3586-3591.
[16]曹世琦, 许贤荣, 冯进, 等. 基于Logistic回归模型分析维持性血液透析患者肌少症的危险因素及其对患者生活质量, 负性情绪及生存状况的影响[J]. 现代生物医学进展, 2022, 22(21): 4180-4184, 4111.
[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(7): 1270-1275.
[18]戴祺洁, 陶静, 华建武, 等. 维持性血液透析患者肌少症发生情况及其影响因素分析[J]. 实用临床医药杂志, 2020, 24(12): 103-106.
[19]周起帆, 尹丽霞, 张海林, 等. 中青年维持性血液透析患者肌少症预测模型的构建与验证[J]. 实用临床医药杂志, 2022, 26(5): 44-47, 53.
[20]丁捷, 刘红娇, 黄鑫, 等. 维持性血液透析患者肌少症发病的临床表现及与TNF-α基因多态性的关系研究[J]. 中国中西医结合肾病杂志, 2021, 22(8): 725-727.
[21]蔡茜, 张祖隆. 终末期肾脏病行维持性血液透析患者发生肌少症的相关影响因素分析[J]. 实用临床医药杂志, 2023, 27(10): 84-90.