Sarcopenia among chronic kidney disease patients attending a renal clinic in Northwest Ethiopia: a cross-sectional study of prevalence, risk factors and clinical implications
Melaku Mekonnen Agidew, Girma DersoBackground
Sarcopenia is a skeletal muscle disorder characterised by reduced muscle strength, low muscle mass and impaired physical performance. It is increasingly recognised among patients with chronic kidney disease (CKD) and is associated with adverse clinical outcomes. However, evidence on sarcopenia among CKD patients in Ethiopia remains limited.
Aim
To assess the prevalence of sarcopenia and its associated factors among adult CKD patients attending a tertiary hospital in Northwest Ethiopia.
Methods
A hospital-based cross-sectional study was conducted among adult CKD patients attending the renal clinic of Felege Hiwot Comprehensive Specialised Hospital from September to November 2022. All eligible patients during the study period were consecutively included. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People 2 criteria, incorporating measurements of muscle strength, muscle mass and physical performance. Sociodemographic, clinical, anthropometric and biochemical data were collected using structured tools and laboratory analysis. Multivariable logistic regression analysis was performed to identify factors associated with sarcopenia, with statistical significance set at p<0.05.
Results
A total of 120 consecutive CKD patients were included, containing 60 patients without end-stage renal disease (ESRD) and 60 patients with ESRD. Among CKD patients without ESRD, 5 (8.3%), 13 (21.7%), 26 (43.3%) and 16 (26.7%) were classified as CKD stages 1, 2, 3 and 4, respectively. The prevalence of sarcopenia was significantly higher among patients with ESRD than among those without ESRD (28.3% vs 10.0%, p=0.01). The distribution of sarcopenia stages also differed significantly between the two groups (p=0.02). In multivariable analysis, decreased high-density lipoprotein, elevated triacylglycerol, increased fasting blood glucose, hypertension and frailty were significantly associated with sarcopenia. Furthermore, overall sarcopenia revealed significant associations with creatinine (r=−0.291, p=0.001), estimated glomerular filtration rate (r=0.260, p=0.004), frailty (r=0.566, p<0.001), malondialdehyde (r=−0.392, p<0.001) and total antioxidant capacity (r=0.455, p<0.001).
Conclusion
Sarcopenia was predominant among CKD patients and was more common among those with ESRD. It was correlated with metabolic abnormalities, inflammation, oxidative stress and frailty. The findings indicate the necessity of routine screening and integrated management strategies in CKD patients. However, further longitudinal multicentre studies are needed to better understand the burden and determinants of sarcopenia in this population.