Sarcopenia On The Health-related Quality Of Life Of Patients With Maintenance Hemodialysis

Objective:To research sarcopenia on the Health-Related Quality of Life of patients with Maintenance Hemodialysis(MHD).Methods:A cross-sectional study was conducted with 60 nonhospitalized maintenance hemodialysis patients in the First Affiliated Hospital Of Kunming Medical University and Kidney Disease Hospital in Yunnan who had been maintained for at least 3 months and in a stable condition.Clinical case table(including gender,height,age,duration of dialysis,primary disease,relevant laboratory data)was established for each of the research object.Bioelectrical Impedance Analysis(BIA)was used to measure the Skeletal Muscle Mass(SMM),and calculate the Skeletal Muscle Index(SMI),SMI=SMM/height2,Handgrip strength(HGS)was measured by grip dynamometer,Usual Gaitspeed(UGS)method was used to assess patients muscle function.In accordance with the diagnostic criteria of European Group on Sarcopenia in Older People(EWGSOP),according to the results of SMI,grip strength and usual gaitspeed,the patients were divided into four groups:without sarcopenia,presarcopenia,sarcopenia,and severe sarcopenia.Results:1 General information:60 cases of MHD patients were enrolled,31 cases were male(51.7%),29 cases were female(48.3%).mean age 48.48 ± 14.36 years old.the average duration of dialysis was 60(26?78)months.primary disease:33 cases of chronic glomerulonephritis(55%),10 cases of hypertensive nephropathy(16.7%),6 cases diabetic nephropathy(10%),2 cases of polycystic kidney(3.3%),2 cases of obstructive nephropathy(3.3%),2 cases of interstitial nephritis(3.3%),5 cases of unknown(8.3%).2.The distribution of sarcopenia:according to the diagnostic criteria formulated by EWGSOP,60 cases of MHD patients,without sarcopenia group 34 cases(56.7%),presarcopenia group 13 cases(21.7%),sarcopenia group 9 cases(15.0%),severe sarcopenia group 4cases(6.7%).3.Baseline characteristics and laboratory data of subjects:significant differences were observed in age,gender,grip strength,BMI,25 hydroxy vitamin D3,hs-CRP,total cholesterol(P<0.05).However,no significant difference was noted with respect to duration of dialysis,primary disease,SMI,pace,KT/V,PA,TP,serum calcium,phosphorus,PTH,IL-6,TNF-a,TG,HDL-c,LDL-c(P>0.05).4.According to the age ? 60 years and age>60 years divided the patients into two groups,the incidence of sarcopenia in adult group was 38.8%(19/49),below elderly people group 63.6%(7/11),the difference was statistically significant(X2= 1.894,P=0.008).5.The patients by gender was divided into two groups,characterized by sarcopenia incidence of male 74.19%(23/31)than women10.34%(3/29),the difference was statistically significant(X2=30.209,P=0.000).6.The risk factors of sarcopenia:Whether to happen sarcopenia as the dependent variable,the significant factors of age,gender,grip strength,BMI,25 hydroxy-vitamin D3,hs-CRP,TC and so on eight variable as the independent variable in logistic regression analysis,the results showed that after controlling confounding factors related,the increase levels of the hs-CRP was the risk factor of sarcopenia in MHD patients(OR=8.379,95%CI=1.184-59.315,P<0.05),the difference was statistically significant.7.Sarcopenia on the quality of life of patients with MHD:Statistically significant difference were found in physical function(PF),body pain(BP),Energy,physical health(PH),the total score among the three groups of presarcopenia,sarcopenia and severe sarcopenia(P<0.05);Further comparison between two groups have found that the quality of life in the physical function(PF),role limitation due to physical problems(RP),body pain(BP),general health(GH),Energy(Energy),Emotion Well-Being(EWB),Mental health(MH),physical health(PH)and the total score difference was statistically significant(P<0.05);The severity of sarcopenia was negatively correlated with fitness(PF),body pain(BP),general health(GH),Energy(Energy),the physical health condition(PH),mental health(MH),and total score,the difference was statistically significant(P<0.05).Conclusions:1.The incidence of sarcopenia in MHD patients was 43.3%,the incidence rate of sarcopenia in elderly patients with MHD was higher than that of young and middle-aged,male MHD patients has a higher incidence rate of sarcopenia than female MHD patients.2.MHD patients with higher levels of hs-CRP,namely the inflammatory state is showed a higher risk of sarcopenia.3.sarcopenia affecting the quality of life of MHD patients,mainly from the fields of physical function(PF),role limitation due to physical problems(RP),body pain(BP),Energy(Energy),general health(GH),physical health(PH).