Polypharmacy and sarcopenia in patients on hemodialysis: results from the SARC-HD study

We investigated the association between polypharmacy and sarcopenia in patients on hemodialysis.

Cross-sectional data from the SARC-HD study were analyzed. Patients were classified according to the number of prescribed medications as no polypharmacy (0-4), polypharmacy (5-9), and hyperpolypharmacy (≥ 10). Sarcopenia was diagnosed and staged according to the adapted EWGSOP2 consensus.

955 patients (48% ≥ 60 years, 61% male) were analyzed. Polypharmacy and hyperpolypharmacy were observed in 50% and 26% of patients, respectively. Patients with hyperpolypharmacy had poorer physical function compared to the no polypharmacy group. Low muscle strength was found in 45%, while sarcopenia (confirmed and severe stages) in 21% of the cohort. Patients in the polypharmacy groups had higher prevalence of low muscle strength, but similar sarcopenia rates to those in the no polypharmacy group. Only hyperpolypharmacy was independently associated with low muscle strength (64% higher adjusted odds, 95% CI 1.10-2.46), whereas no significant associations were observed with sarcopenia. Also, each addition of two medications was independently associated with 10% higher adjusted odds (95% CI 1.02-1.20) of low muscle strength.

In patients on hemodialysis, the number of medications and hyperpolypharmacy were independently associated with low muscle strength, but not with sarcopenia per se.