Recent Sarcopenia Definitions-Variability in Prevalence and Disability Associations in Peritoneal Dialysis Patients

Area of Science:

• Nephrology
• Geriatrics
• Musculoskeletal Health

Background:

• Sarcopenia is prevalent in chronic kidney disease (CKD) but lacks unified diagnostic criteria.
• Recent definitions, like the Sarcopenia Definitions and Outcomes Consortium (SDOC), focus on muscle function over mass.
• The utility of these newer definitions and their link to functional disability in end-stage kidney disease (ESKD) patients on peritoneal dialysis (PD) is understudied.

Purpose of the Study:

• To evaluate sarcopenia prevalence and concordance using various definitions in Thai PD patients.
• To assess the association between sarcopenia and functional limitations in this population.
• To compare older and newer sarcopenia diagnostic criteria in the context of PD.

Main Methods:

• Cross-sectional study of 384 Thai PD patients with complete sarcopenia measurements (BIA, handgrip strength, gait speed).
• Patients classified using FNIH, IWGS, EWGSOP2, AWGS2019, and SDOC definitions.
• Functional disability assessed via Barthel Activities of Daily Living (ADL) score; associations with dependency analyzed using multivariable logistic regression.

Main Results:

• Sarcopenia prevalence varied significantly (8.3% FNIH to 44.5% SDOC).
• Agreement between definitions was mostly poor, except for EWGSOP2 and IWGS.
• Functional limitations were more common in sarcopenic patients (except IWGS). FNIH and SDOC definitions were significantly associated with dependency.
• Low muscle strength was prevalent (58.6%) and linked to higher functional limitations and dependency.

Conclusions:

• Sarcopenia is common in PD patients, with significant variability in prevalence and functional associations across definitions.
• Low muscle strength is a key indicator of functional impairment in PD patients.
• While SDOC shows association with functional deficits, it may overdiagnose sarcopenia in PD; further research is needed to establish clinically relevant criteria for this group.