Kang Seok Hui, Kim A Young, Do Jun Young
Division of Nephrology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.
Kidney Res Clin Pract. 2022 Nov;41(6):741-752. doi: 10.23876/j.krcp.21.278. Epub 2022 Jul 19.
Further studies are needed to identify whether muscle mass, muscle strength, or sarcopenia is the best indicator of survival in patients undergoing peritoneal dialysis (PD). We aimed to compare the association of sarcopenia and its components with survival in patients undergoing PD.
We identified all patients with PD (n = 199). We routinely recommended handgrip strength (HGS) and lean mass measurements using dual energy X-ray absorptiometry in all patients with PD. Sarcopenia was defined using cutoff values from the Asian Working Group for Sarcopenia. We evaluated the patient and technique survival rates.
The number of patients with low HGS was 95 (47.7%). The median follow-up interval was 17 months (interquartile range, 13-21 months). Kaplan-Meier curve analysis showed that patients with low HGS or sarcopenia had poorer patient and technique survival compared with patients with normal HGS or without sarcopenia. Cox regression analysis showed that patients with low HGS had greater hazard ratios for patient death and technique failure compared with those with normal HGS. However, patients with low muscle mass were not significantly higher hazard ratios for patient death or technique failure compared with those with normal muscle mass. Patients with sarcopenia had significantly greater hazard ratios for patient death or technique failure than those without sarcopenia only in univariate analysis.
The present study demonstrated that HGS may be superior to muscle mass or sarcopenia for predicting patient or technique survival in patients undergoing PD.
需要进一步研究以确定肌肉量、肌肉力量或肌肉减少症是否是腹膜透析(PD)患者生存的最佳指标。我们旨在比较肌肉减少症及其组成部分与PD患者生存的相关性。
我们纳入了所有PD患者(n = 199)。我们常规建议对所有PD患者进行握力(HGS)测量,并使用双能X线吸收法测量瘦体重。根据亚洲肌肉减少症工作组的临界值定义肌肉减少症。我们评估了患者生存率和技术生存率。
HGS低的患者有95例(47.7%)。中位随访时间为17个月(四分位间距,13 - 21个月)。Kaplan-Meier曲线分析显示,与HGS正常或无肌肉减少症的患者相比,HGS低或有肌肉减少症的患者的患者生存率和技术生存率较差。Cox回归分析显示,与HGS正常的患者相比,HGS低的患者的患者死亡和技术失败风险更高。然而,与肌肉量正常的患者相比,肌肉量低的患者的患者死亡或技术失败风险并没有显著升高。仅在单因素分析中,有肌肉减少症的患者的患者死亡或技术失败风险比没有肌肉减少症的患者显著更高。
本研究表明,对于预测PD患者的患者生存率或技术生存率,HGS可能优于肌肉量或肌肉减少症。