血液透析患者的多重用药与肌肉减少症：SARC-HD研究结果
Polypharmacy and sarcopenia in patients on hemodialysis: results from the SARC-HD study.
作者信息
Duarte Marvery P, Marinheiro Nicolle P, Junior Odimar Q, Nóbrega Otávio T, Roure Jéssica G, Vieira Fábio A, Santana Jacqueline F, Silva Maryanne Z C, Mondini Dario R, Disessa Henrique S, Adamoli Angélica N, Bündchen Daiana C, Soares Antonio Vinicius, Krug Rodrigo R, Bohlke Maristela, Inda-Filho Antônio J, Reboredo Maycon M, Wesley Moises, Ribeiro Heitor S
机构信息
Faculty of Health Sciences, University of Brasilia, Brasília, Brazil.
University Center ICESP, Brasília, Brazil.
出版信息
Aging Clin Exp Res. 2025 Jun 18;37(1):189. doi: 10.1007/s40520-025-03101-9.
BACKGROUND
We investigated the association between polypharmacy and sarcopenia in patients on hemodialysis.
METHODS
Cross-sectional data from the SARC-HD study were analyzed. Patients were classified according to the number of prescribed medications as no polypharmacy (0-4), polypharmacy (5-9), and hyperpolypharmacy (≥ 10). Sarcopenia was diagnosed and staged according to the adapted EWGSOP2 consensus.
RESULTS
955 patients (48% ≥ 60 years, 61% male) were analyzed. Polypharmacy and hyperpolypharmacy were observed in 50% and 26% of patients, respectively. Patients with hyperpolypharmacy had poorer physical function compared to the no polypharmacy group. Low muscle strength was found in 45%, while sarcopenia (confirmed and severe stages) in 21% of the cohort. Patients in the polypharmacy groups had higher prevalence of low muscle strength, but similar sarcopenia rates to those in the no polypharmacy group. Only hyperpolypharmacy was independently associated with low muscle strength (64% higher adjusted odds, 95% CI 1.10-2.46), whereas no significant associations were observed with sarcopenia. Also, each addition of two medications was independently associated with 10% higher adjusted odds (95% CI 1.02-1.20) of low muscle strength.
CONCLUSIONS
In patients on hemodialysis, the number of medications and hyperpolypharmacy were independently associated with low muscle strength, but not with sarcopenia per se.
背景
我们研究了血液透析患者多重用药与肌肉减少症之间的关联。
方法
分析了SARC-HD研究的横断面数据。根据处方药物数量将患者分为无多重用药（0-4种）、多重用药（5-9种）和超多重用药（≥10种）。根据修订后的EWGSOP2共识诊断并分期肌肉减少症。
结果
分析了955例患者（48%≥60岁，61%为男性）。分别有50%和26%的患者存在多重用药和超多重用药情况。与无多重用药组相比，超多重用药患者的身体功能较差。45%的患者存在低肌肉力量，而该队列中21%的患者存在肌肉减少症（确诊和严重阶段）。多重用药组患者低肌肉力量的患病率较高，但肌肉减少症发生率与无多重用药组相似。只有超多重用药与低肌肉力量独立相关（调整后的优势比高64%，95%CI 1.10-2.46），而与肌肉减少症未观察到显著关联。此外，每增加两种药物与低肌肉力量调整后的优势比独立升高10%（95%CI 1.02-1.20）相关。
结论
在血液透析患者中，药物数量和超多重用药与低肌肉力量独立相关，但与肌肉减少症本身无关。
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