ABSTRACT
OBJECTIVE: Screening tools for the assessment of sarcopenia in clinical practice are greatly needed. Routinely, some dialysis centers assess quality of life through the 36-Item Short Form Survey (SF-36), which include 10 questions about physical function. Thus, we investigated the accuracy of the 10-Item Physical Function scale (PF-10) to identify sarcopenia among patients on hemodialysis. METHODS: A cross-sectional, multicenter study that included adult patients on hemodialysis. The revised European Working Group on Sarcopenia in Older People was used to diagnose sarcopenia. The 10 questions about daily activities from the SF-36 questionnaire were used to appoint the PF-10, where the final score could range from 10 to 30, and the lower the worse the physical function. The PF-10 accuracy to identify confirmed sarcopenia (low muscle strength + low muscle mass) was assessed through a receiver operating characteristic (ROC) curve and the cut-off was calculated using the Youden index. RESULTS: One hundred and eighty-five patients were included (median age, 59 years; 45% female). Prevalence of confirmed sarcopenia was 31.4%. The median PF-10 score was 23 (interquartile range: 10-30) and a significant association with all sarcopenia measurements was found (all P < 0.05). The best cut-off calculated from the ROC curve was ≤ 26 points (area under the curve = 0.69, 95% confidence interval 0.61-0.77) with sensitivity and specificity of 96.6% and 71.0%, respectively. Moreover, patients with ≤ 26 points (n=133, 72%) had a higher prevalence of low muscle strength by handgrip (53 vs. 19%; P<0.001) and five-time sit-to-stand (41 vs. 10%; P<0.001), low gait speed (44 vs. 19%; P=0.002), confirmed sarcopenia (39 vs. 11%; P<0.001), and severe sarcopenia (26 vs. 4%; P=0.001), but not low muscle mass (49 vs. 35%; P=0.08), in comparison with those > 26 points (n=52, 28%). CONCLUSION: The 10-Item Physical Function Scale (PF-10) may be a useful physical dysfunction and sarcopenia screening tool in patients on hemodialysis. A PF-10 threshold of around 26 points appeared to display the fairest accuracy for diagnosing sarcopenia.
ABSTRACT
BACKGROUND: Sarcopenia has been associated with adverse outcomes in patients with chronic kidney disease (CKD), particularly in those undergoing hemodialysis (HD). However, the trajectories across sarcopenia stages, their determinants, and associations with adverse clinical outcomes have yet to be comprehensively examined. METHODS: The SARC-HD is a multicenter, observational prospective cohort study designed to comprehensively investigate sarcopenia in patients on HD. Eligibility criteria include adult patients undergoing HD for ≥ 3 months. The primary objective is to investigate the trajectories of sarcopenia stages and their potential determinants. Secondary objectives include evaluating the association between sarcopenia and adverse clinical outcomes (i.e., falls, hospitalization, and mortality). Sarcopenia risk will be assessed by the SARC-F and SARC-CalF questionnaire. Sarcopenia traits (i.e., low muscle strength, low muscle mass, and low physical performance) will be defined according to the revised European Working Group on Sarcopenia in Older People and will be assessed at baseline and after 12 follow-up months. Patients will be followed-up at 3 monthly intervals for adverse clinical outcomes during 24 months. DISCUSSION: Collectively, we expect to provide relevant clinical findings for healthcare professionals from nephrology on the association between sarcopenia screening tools (i.e., SARC-F and SARC-CalF) with objective sarcopenia measurements, as well as to investigate predictors of trajectories across sarcopenia stages, and the impact of sarcopenia on adverse clinical outcomes. Hence, our ambition is that the data acquired from SARC-HD study will provide novel and valuable evidence to support an adequate screening and management of sarcopenia in patients on HD.
