Among patients with end-stage kidney disease (ESKD) receiving maintenance dialysis, sarcopenia is a frequent, yet under-recognized, complication. Wannasit Wathanavasin, MSc, and colleagues in Thailand conducted a systematic review and meta-analysis designed to assess the global prevalence of sarcopenia and examine whether the condition has an impact on clinical outcomes, particularly cardiovascular events and mortality in dialysis patients.
Results of the study were reported during a poster session at the American Society of Nephrology Kidney Week 2022. The poster was titled The Prevalence of Sarcopenia and Its Impact on CV Events and Mortality Among ESKD Patients on Dialysis: A Systematic Review and Meta-Analysis.
Eligible studies were identified via searches in PubMed, Scopus, and Cochrane Central Register of Controlled Trials through March 31, 2022. Cross-sectional and cohort studies that reported the prevalence of sarcopenia were included. Other outcomes of interest were low muscle mass and low muscle strength, as well as adverse events, including cardiovascular events and death.
The pooled prevalence rate was calculated using the random-effects model. Associations between sarcopenia and clinical outcomes were expressed as odds ratio (OR) and 95% CI. The presence of heterogeneity was measured using Cochran’s Q statistic and I2 test. Funnel plot and Egger’s test also tested publication bias.
The meta-analysis included 41 studies representing 7576 patients. The pooled prevalence of sarcopenia in patients on dialysis was 25.6% (95% CI, 22.1%-29.4%). Among various diagnostic criteria, the highest prevalence was found in the Asian Working Group for Sarcopenia 2019 criteria (36.9%; 95% CI, 30.4%-44.2%).
There was a significant association between sarcopenia and higher mortality risk (adjusted OR [aOR], 1.83; 95% CI, 1.40-2.39) and cardiovascular events (aOR, 3.80; 95% CI, 1.79-8.09). There were independent associations between both low muscle mass and low muscle strength and increased risk of mortality in dialysis patients (OR, 1.71; 95% CI, 1.20-2.44 and OR, 2.15; 95% CI, 1.15-3.07, respectively).
In conclusion, the researchers said, “This meta-analysis revealed that sarcopenia was highly prevalent among dialysis patients and shown to be an important predictor of cardiovascular events and mortality. Future intervention research to alleviate this burden of disease in dialysis patients is needed.”
Source: Wathanavasin W, Banjongjit A, Avihingsanon Y, Praditpornsilpa K, Eiam-Ong S, Susantitaphong P. The prevalence of sarcopenia and its impact on CV events and mortality among ESKD patients on dialysis: a systematic review and meta-analysis. TH-PO790. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2022; November 3, 2022; Orlando, Florida.