Risk factors for incident or persistent SARC-F-defined sarcopenia in patients with end-stage kidney disease: a cohort...

Sarcopenia, characterized by progressive muscle/function loss, is prevalent in chronic kidney disease (CKD), associated with adverse outcomes. Identifying factors influencing its progression in end-stage kidney disease (ESKD) is essential for targeted interventions. This study aimed to determine key factors for incident or persistent sarcopenia risk status in ESKD patients.

We prospectively enrolled ESKD patients on chronic hemodialysis in 2020, collecting clinical, anthropometric, laboratory, and physical function data. Screening for sarcopenia status was assessed at baseline and one year later, using the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire. Primary outcome was persistent or incident SARC-F-defined sarcopenia. Risk factors were analyzed using multiple regression models.

Among 146 patients (60.8 ± 11.9 years; 66.4 % male), 26 (17.8 %) had incident or persistent SARC-F-defined sarcopenia. They were older, had more comorbidities (diabetes, peripheral vascular disease, stroke), lower albumin and potassium levels, and higher baseline SARC-F scores and frailty. Regression analyses considering demographic/physical data, comorbidity, and medications identified advanced age (odds ratio (OR) 1.079, 95 % confidence interval (CI) 1.024-1.138) and prior stroke (OR 7.346, 95 % CI 1.227-43.97) as significant risk factors. After incorporating laboratory markers, baseline SARC-F, and frailty status, only prior stroke (OR 18.522, 95 % CI 2.278-150.6) and higher baseline SARC-F scores (OR 2.422, 95 % CI 1.676-3.501) were associated with increased risk.

Our findings highlight a subgroup of ESKD patients at an elevated risk of SARC-F-defined sarcopenia persistence or development, including prior stroke and poorer baseline sarcopenia screening results.