Risk factors for sarcopenia and its association with restless legs syndrome and pruritus in hemodialysis patients: A single-center, cross-sectional study.

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Risk factors for sarcopenia and its association with restless legs syndrome and pruritus in hemodialysis patients: A single-center, cross-sectional study.

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Co-author 1

Dionys NSANZABAGENZI nsanzabagenzidionys@gmail.com Kamenge Military Hospital Nephrology Bujumbura Burundi *

Co-author 2

Puzheng Du puzhengdu@smu.edu.cn Zhujiang Hospital of Southern Medical University Anesthesiology Guangzhou China -

Co-author 3

Zefeng Guo 1530681956@qq.com Zhujiang Hospital of Southern Medical University Organ Transplantation Guangzhou China -

Co-author 4

Yuzhu Li 1059091164@qq.com Zhujiang Hospital of Southern Medical University Organ Transplantation Guangzhou China -

Co-author 5

Fengxian Li ligengxian81@smu.edu.cn Zhujiang Hospital of Southern Medical University Anesthesiology Guangzhou China -

Co-author 6

Hongxin Niu nhongxin@126.com Zhujiang Hospital of Southern Medical University General Practice Guangzhou China -

Co-author 7

Ding Liu banbybear01@smu.edu.cn Zhujiang Hospital of Southern Medical University Organ Transplantation Guangzhou China -

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Sarcopenia is a major health concern among patients undergoing maintenance hemodialysis (MHD). Restless legs syndrome (RLS) and pruritus are also frequent and distressing complications that impair sleep and quality of life. These conditions may share underlying mechanisms such as inflammation, metabolic imbalance, and malnutrition common in MHD. This study aimed to identify risk factors for sarcopenia and examine its association with RLS and pruritus in MHD patients.

Methods

We conducted a cross-sectional study at Zhujiang Hospital, Guangzhou, Guangdong Province, China, between June and September 2024. We included 200 MHD patients aged ≥18 years who had been on regular HD for at least three months. We collected demographic, clinical, laboratory, and anthropometric data. We measured muscle mass, handgrip strength, and muscle function using BIA, a hand dynamometer, and gait speed tests, respectively. We defined sarcopenia according to the 2019 AWGS criteria. We diagnosed RLS according to the International Restless Leg Syndrome Study Group (IRLSSG) criteria, and we evaluated pruritus using the worst itching numeric rating scale (WI-NRS).

Results

Sarcopenia was present in 69% (138/200) of patients. Affected patients were older (62.6 ± 11.5 vs. 51.7 ± 14.1 years; p < 0.001) and more often male (p = 0.045). Multivariate analysis showed associations between sarcopenia, higher hs-CRP (p = 0.045), and lower albumin (p = 0.005). Neither RLS nor pruritus severity were linked to sarcopenia.

Conclusion

Sarcopenia is highly prevalent in MHD patients, with age, male sex, inflammation, and malnutrition as major contributors. Routine screening and early interventions targeting nutrition, inflammation, and physical function may help prevent sarcopenia and related complications. We did not find a significant association between sarcopenia and RLS or pruritus.

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