Differences in Prevalence of Muscle Weakness (Sarcopenia) in Haemodialysis Patients Determined by Hand Grip Strength Due to Variation in Guideline Definitions of Sarcopenia.

BACKGROUND: Muscle weakness is associated with increased mortality, and hemodialysis (HD) patients are at an increased risk for muscle loss. There is no agreed definition for muscle weakness, so we determined whether using different cut-off criteria recommended by guideline groups altered the prevalence in HD patients.

METHODS: We measured hand grip strength (HGS) in HD outpatients, comparing HGS with clinical guideline cut-offs (European Working Group on Sarcopenia in Older People [EWGSOP] and North American Foundation for the National Institutes of Health Sarcopenia Project [FNIH]) used to define muscle wasting (sarcopenia) with age-matched and gender-matched normative data.

RESULTS: We studied 459 patients, 61.4% male, 47.3% diabetic. The prevalence of muscle weakness was significantly different when measuring HGS; 84.5% using the EWGSOP cut-off and 73.2% with FNIH criteria, and 75.2% using North American normative data and 56.6% U.K. normative data (P < .01). On logistic regression, muscle weakness was associated with age (odds ratio [OR] 1.05, P < .001), weight (OR 0.96, P < .001), serum albumin (OR 0.89, P = .007), and being nondiabetic (OR 0.31, P = .001). Of patients with no comorbidity, 66.7% were weak when compared with 93.8% with the highest comorbidity scores (P < .001).

CONCLUSION: There is currently no agreed universal definition for sarcopenia, but the EWGSOP and FNIH advocate HGS cut-offs as part of their definition. The prevalence of muscle weakness varies according to cut-off and whether age-matched and gender-matched normative data are used. In addition, patient characteristics in terms of age and comorbidity determine the prevalence of muscle weakness.