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Calf circumference predicts sarcopenia and all-cause mortality in older patients undergoing maintenance hemodialysis:

Yan Shen1,2, Hongmin Qin2, Xiaosu Liu2

  • 1Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|July 6, 2025
PubMed

Insights

Calf circumference (CC) effectively predicts sarcopenia and mortality in older patients on maintenance hemodialysis (MHD). Lower CC is linked to higher risks, establishing it as a crucial health indicator for this population.

Area of Science:

  • Gerontology
  • Nephrology
  • Clinical Nutrition

Background:

  • The predictive role of calf circumference (CC) for sarcopenia and mortality in maintenance hemodialysis (MHD) patients is debated.
  • This study aimed to evaluate CC's predictive value, optimal thresholds, and association with mortality in older MHD patients.

Purpose of the Study:

  • To assess calf circumference as a predictor of sarcopenia in older adults undergoing maintenance hemodialysis.
  • To determine the optimal calf circumference thresholds for identifying sarcopenia in male and female MHD patients.
  • To investigate the association between calf circumference, sarcopenia, and 2-year mortality in this patient group.

Main Methods:

  • An observational cohort study involving 979 older adult MHD patients.
  • Sarcopenia diagnosis based on the European Working Group on Sarcopenia in Older People criteria.
  • Logistic regression, ROC analysis, Kaplan-Meier, and Cox regression were used to analyze CC, sarcopenia, and mortality.

Main Results:

  • Sarcopenia prevalence was 61.1% in the study population.
  • Low calf circumference (CC) and sarcopenia were independent predictors of mortality in older MHD patients.
  • Optimal CC cutoffs were identified as 32.5 cm for men and 31.9 cm for women, with high sensitivity and specificity.

Conclusions:

  • Calf circumference is a valuable and independent predictor of sarcopenia in older patients undergoing maintenance hemodialysis.
  • Reduced calf circumference is significantly associated with increased mortality risk in this vulnerable patient population.
Abstract

Keywords:
all‐cause mortalitycalf circumferencemaintenance hemodialysisolder adultssarcopenia

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