Relationship Between Residual Diuresis and Sarcopenia in Patients on Hemodialysis

To assess the association of residual diuresis with sarcopenia in patients with chronic kidney disease on hemodialysis.

Through a cross-sectional study, patients on hemodialysis were subjected to a Dual-Energy Radiologic Absorption examination to record muscle mass. Based on the volume of urine collected in 24 hours, patients were classified as anuric (diuresis ≤100 mL/day) or nonanuric (diuresis > 100 mL/day). Functional performance was evaluated by Short Physical Performance Battery (SPPB) and muscle strength by handgrip strength and 5-repetition sit-to-stand test. The association between the absence of residual urine and the presence of sarcopenia, low SPPB, and low muscle strength was analyzed using a binary logistic regression model.

Ninety-two patients, with a mean age of 54.4 years (95% confidence interval [CI] 51.3-57.4) and with a mean diuresis volume of 476.3 mL/day (95% CI 320.4-632.2) were evaluated (48 anuric and 44 nonanuric). Anuric patients had a 2.77 (95% CI 1.14-6.73) times greater probability of sarcopenia and had a 3.55 (1.14-11.0) times greater probability of low SPPB regardless of gender, age, and time on dialysis. Gender was the other associated variable for the presence of sarcopenia, with males having a 3.30 (95% CI 1.34-8.13) times higher risk. There were no associations with muscle strength.

The absence of residual diuresis in patients on hemodialysis is associated with a higher risk of sarcopenia and low functional performance.