Predialysis assessments underestimate sarcopenia prevalence

Eighty-seven patients (mean age 66.6±12.8 years, 70.1 percent men) on MHD participated in the study, all of whom underwent bioelectrical impedance analysis for body composition measurements. Handgrip strength and physical performance were evaluated using a quantitative handgrip dynamometer and the 6-m usual gait speed test, respectively. All assessments were conducted before and after dialysis.

Postdialysis measurements identified 20 sarcopenic patients (23.0 percent), who were significantly older and had lower body mass index and postdialysis weight than their nonsarcopenic counterparts. Looking at both pre- and postdialysis measurements, the researchers found that the rate of sarcopenia increased with age.

However, the prevalence rates were much lower when using predialysis measurements. For instance, only 6.9 percent of participants aged 40–59 years were deemed sarcopenic during predialysis assessments, increasing to 16.7 percent among 60–80-year-olds and to 18.8 percent among >80-year-olds. In contrast, postdialysis assessment found a sarcopenia prevalence of 62.5 percent in the oldest age group.

Notably, predialysis measurements missed almost half of sarcopenic participants as compared with postdialysis assessments (13.8 percent vs 23 percent).

“Our findings emphasize the timing of BIA measurement to address sarcopenia diagnosis. Although predialysis measurement is preferred by both patients and dialysis centre staff, we still recommend postdialysis measurement for greater reliability and lower omission diagnostic rate,” the researchers said.