Screening Tests for Sarcopenia in Patients with Chronic Kidney Disease.

BACKGROUND: Patients with chronic kidney disease (CKD) are at increased risk of muscle wasting. Screening tools for sarcopenia, including the Sarc-F questionnaire are now advocated for clinical practice. We wished to compare using the Sarc-F tool with standard measurements of hand grip (HGS) strength and appendicular muscle mass index (APMI). METHODS: We retrospectively reviewed Sarc-F questionnaires completed by patients with CKD, along with contemporaneous measurements of HGS and bioimpedance measured APMI. RESULTS: 146 patients; 94 male (64.4%), mean age 70.5 ± 15 years, body mass index 28.7 ± 6.3 kg/m2 were screened, and 46 screened positive for sarcopenia, with a lower median HGS (19.3 (14.2-24.7) vs 25.6 (19.7-32) kg) and greater body fat (38.3 ± 11.5 vs 30.6 ± 11.5%), both p < 0.001,, with more non-white ethnicity (63 vs 44%), p < 0.05, but there were no other differences. Step-wise adding HGS, and then APMI cut offs, the prevalence of sarcopenia fell from 31.5% to 20.7-24.7% and 2.8-4.8% respectively, with 45.5-62.8% having reduced HGS strength and 11.0-28.1% reduced APMI, depending on which guidelines were applied. Using the most recent European, and ethnicity adjusted cut-off values then there were no statistical differences in the prevalence of sarcopenia with or without the Sarc-F screening tool. CONCLUSIONS: By starting with the Sarc-F screening tool, a number of our patients with CKD would then have been excluded from subsequent investigation for sarcopenia. However, overall screening with the Sarc-F tool did not lead to a significant difference in the prevalence of sarcopenia, when using current and ethnicity adjusted guidelines, compared to combining HGS and APMI alone.