Factors Associated with Risk of Sarcopenia among Hemodialysis Patients in Selected Dialysis Centers in Selangor

Chow, Yu Fei (2022) Factors Associated with Risk of Sarcopenia among Hemodialysis Patients in Selected Dialysis Centers in Selangor. [Project Paper] (Submitted)

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Abstract

Sarcopenia was first described in the geriatric population but is gaining attention among hemodialysis patients as growing evidence revealed a higher prevalence of sarcopenia among hemodialysis-dependent chronic kidney disease patients than in the geriatric population. Notwithstanding sarcopenia is multifaceted as shown in earlier studies, such information remains scarce in the local context. Therefore, this cross-sectional study aimed to elucidate factors associated with risk of sarcopenia among hemodialysis patients in Selangor. A set of pre-tested interviewer-administrated questionnaires was used to collect pertinent information from hemodialysis patients, while the presence of comorbidities, number of medications used, dialysis vintage, height and dry weight of the patients were retrieved as secondary data from their dialysis record. Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire-Short Form (IPAQ-SF), sun exposure questionnaire, Mini Nutrition Assessment (MNA), and SARC-F questionnaire were used to assess sleep quality, physical activity level, sunlight exposure, nutritional status and risk of sarcopenia in the subjects, respectively. IBM SPSS version 26 was used in the statistical analysis, with a significance level set at p<0.05. A total of 100 subjects (55 males, 45 females) with a mean age of 60±14 years old were recruited from five hemodialysis centers in Klang and Petaling districts, Selangor using purposive sampling. The majority of the subjects were Chinese (51%), married (76%) and lived together with family or others (92%). The subjects had a mean Body Mass Index (BMI) of 23.73±5.12 kg/m2, with more than half of them (53%) having protein-energy malnutrition (defined as BMI <23 kg/m2). While abdominal obesity was evident in the subjects whereby seven in 10 of the subjects had excessive waist circumference, the majority of the subject had normal calf circumference. The mean dialysis vintage of the subjects was 4.85±4.22 years. Hypertension was dominant (88%) while type 2 diabetes mellitus was prevalent (62%) among the subjects, with more than 70% of the subjects having polypharmacy. A total of 64% and 48% of the subjects had poor sleep quality on non-hemodialysis days (NHDDs) and hemodialysis days (HDDs), respectively. A majority of the subjects (78%) had low physical activity while sun exposure was low. Nutritional status of the subjects was poor, with one-third of the subjects at risk of malnutrition when measured using MNA. There were three out of 10 subjects who had risk of sarcopenia. A higher risk of sarcopenia was significantly associated with old age (r=0.348, p<0.001), increased waist circumference in female (r=0.348, p<0.001), a higher Charlson Comorbidity Index (r=0.246, p=0.013), a higher number of medications (r=0.203, p=0.042), poor sleep quality on both NHDDs (r=0.531, p<0.001) and HDDs (r=0.461, p<0.001), low physical activity level (r=-0.287, p=0.004), low sun exposure score (r=-0.218, p=0.029) and suboptimal nutritional status (r=-0.239, p=0.017). Sleep components, namely subjective sleep quality (p<0.001), sleep latency (p=0.002), habitual sleep efficiency on NHDDs (p=0.001) and daytime dysfunction (p=0.009) were also significantly associated with risk of sarcopenia. The present study highlighted several factors associated with risk of sarcopenia that were indeed modifiable, which should be considered by relevant healthcare professionals in the formulation of appropriate and effective intervention in reducing risk of sarcopenia among the hemodialysis population.

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Mr Khoirul Asrimi Md Nor
Date Deposited:	07 Aug 2023 02:17
Last Modified:	07 Aug 2023 02:17
URI:	http://psaspb.upm.edu.my/id/eprint/988

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