Risk Factors Affecting Muscle Mass Decline in Maintenance Hemodialysis Patients

Abstract

Objective. There is a high prevalence of sarcopenia in maintenance hemodialysis (MHD) patients, which is known to be associated with increased mortality. This study is aimed at analyzing the risk factors affecting muscle mass decline in MHD patients. Methods. This retrospective study included MHD patients who underwent two body composition assessments in October 2013 and November 2017. Depending on whether there was muscle loss or not, the patients were divided into a normal muscle mass (NMM) group and a muscle mass decline (MMD) group. According to the muscle mass decline rate, patients in the MMD group were further classified into a low-rate group and a high-rate group. Biochemical variables, serum vitamin concentrations, anthropometric data, SGA, muscle mass, handgrip, and daily steps were assessed. Risk factors for muscle mass decline were screened by multivariate logistic analysis and linear regression analysis. Results. Of the 72 MHD patients included in this study, 33 were male and 39 were female with a mean age of 56.80±10.86 years and a mean dialysis duration of 7.50±5.20 years. Age (P=.014) and serum 25(OH)D (P=.040) were found to be associated with a higher risk of muscle mass decline after adjusting for gender, dialysis vintage, albumin, and hs-CRP (P=.040). Further analysis found that dialysis vintage (β=0.285, P=.030), 25(OH)D (β=-0.351, P=.007), and log NT-proBNP (β=0.312, P=.020) were risk factors associated with the muscle mass decline rate in MHD patients. Conclusion. Age and serum 25(OH)D were associated with a higher risk of muscle mass decline, while 25(OH)D, dialysis vintage, and NT-proBNP were associated with the muscle mass decline rate in MHD patients.