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Sarcopenia is a syndrome characteried by the decline of muscle mass, muscle strenght and physical function, prevalente in individuals with chronic kidney disease (CKD), especially undergoing dialysis treatment. This condition is related to negative consequences such as the risk of falls, increased hospitalization, mortality and public health spending. The SARC-F and SARC-CalF questionnaires are validated instruments for screening sarcopenia, with high sensitivity, easy applicability, non-invasive, low cost, associated with sarcopenia parmeters. The domins assessed in SARC-F are: strength, ability to walk, getting up from a chair, climbing stairs and occurrence of falls in the last year. The SARC-CalF is composed of the SARC-F with an additional measurement of calf circumference. This study aimed to evaluate the relationship between sarcopenia screening, using SARC-F and SARC-CalF, and the occurrence of all-cause mortality in participants with CKD undergoing hemodialysis (HD).
Prospective cohort study, including individuals undergoing HD in a nephrology unit of a public hospital in the Federal District, Brazil, including participants > 18 years of age, both gender, between June 2019 and April 2023. Variables such as age, gender, dialysis vintage in months, comorbidities and causes of CKD were collected through interviews and electronic medical records. Body composition through anthropometry and electrical biompedance, physical function (muscle strength and gait speed), sarcopenia screening by SARC-F and SARC-CalF, nutritional status by the 7-point subjective global assessment (7p-SGA) and laboratory tests were evaluated. Follow-up time for all-cause mortality was 47 months. The Kolmogorov-Smirnov test used to analyse data normality, the T Student, Chi-square and Mann Whitney tests were performed for differences between groups. Spearman and Pearson correlations used for quantitative variables. Cox regression and survival assessment using Kaplan-Meier and the log-rank test. Statistical analyses were performed using the SPPS program, V26, with statistical significance p<0.05.
The sample consisted of 243 participants, age 55.66±14.87 years, 151 (62.14%) men, 132 (54.32%) adults, dialysis vintage 4 [3-360] months. The prevalence of sarcopenia risk using SARC-F and SARC-CalF were 30.50% and 44.90%, respectively. SARC-F correlated negatively with HGS (r= -0.522; p<0.001) and 7p-SGA (r= -0.512; p<0.001). Multivariate analyses identified SARC-F and SARC-CalF as predictors of mortality in individuals undergoing HD. Survival analyses showed statistical significance in the curves between groups stratified by SARC-F (p<0.001) and SARC-CalF (p<0.001) scores.
SARC-F and SARC-CalF are predictors of mortality in individuals undergoing HD, easy to apply, available in clinical practice, associated with parameters of body composition and physical function. Sarcopenia screening allows for early diagnosis and treatment of this condition in individuals with CKD.