Dialysis Vintage Is Partially Associated with Sarcopenia in Patients on Hemodialysis

Abstract

INTRODUCTION: Dialysis-related factors may contribute to sarcopenia, but this has yet to be explored. We investigated the association between dialysis vintage and sarcopenia in patients on hemodialysis. METHODS: This cross-sectional analysis is part of the SARC-HD study. Sarcopenia was assessed according to the revised EWGSOP2 criteria using handgrip strength and calf circumference measurements. We considered sarcopenia as confirmed and severe stages. Patients were stratified into groups according to the quintiles of dialysis vintage months: 3-11; 12-24; 25-43; 44-76; and ≥77. The 12-24 months group was adopted as reference in adjusted binary logistic regressions. RESULTS: A total of 983 patients from 19 dialysis centers were included (67% male, median age 59 years). The median dialysis vintage was 33 months (interquartile range: 14-67), 31% were receiving hemodiafiltration, and 29% had a short daily weekly frequency (≥4 sessions/week). Probable sarcopenia was found in 12%, confirmed in 9%, and severe in 5%. Probable sarcopenia was higher in the 3-11 months group (p = 0.045). In the overall analysis, no significant association was found between dialysis vintage and sarcopenia. However, in sensitivity exploratory analyses excluding patients on hemodiafiltration, the shortest (adjusted odds ratio [aOR] = 2.95, 95% confidence interval [CI]: 1.24-7.00) and longest (aOR = 3.02, 95% CI: 1.22-7.44) dialysis vintage groups showed higher odds of sarcopenia compared to the 12-24 months group. A similar pseudo-U-shaped association was found among patients on conventional weekly frequency (excluding short daily), where the shortest (aOR = 2.88, 95% CI: 1.23-6.74) and longest (aOR = 2.77, 95% CI: 1.17-6.55) dialysis vintage groups were associated with higher odds of sarcopenia. CONCLUSION: The association between dialysis vintage and sarcopenia was observed in conventional hemodialysis regimens. This association seems to be pseudo-U-shaped in the shortest and longest dialysis vintage groups. Future studies should examine how pre-dialysis care and dialysis regimens affect sarcopenia development or progression.