Concomitant sarcopenia and undernutrition: Impact on clinical outcomes in patients undergoing hemodialysis
Sarcopenia and undernutrition are crucial in the cycle of frailty in patients requiring hemodialysis therapy, and their deleterious clinical consequences are well documented. However, little attention has been directed towards examining their combined impact on clinical outcomes. This study aimed to...
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| Veröffentlicht in: | Clinical nutrition ESPEN 2024-10, Vol.63, p.651-658 |
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| creator | Tsujimoto, Naoyuki Matsuzawa, Ryota Kakita, Daisuke Imai, Hiroto Harada, Manae Yoshikoshi, Shun Yamabe, Sachi Osada, Shiwori Shimokado, Kiyoshi Matsunaga, Atsuhiko Tamaki, Akira |
| description | Sarcopenia and undernutrition are crucial in the cycle of frailty in patients requiring hemodialysis therapy, and their deleterious clinical consequences are well documented. However, little attention has been directed towards examining their combined impact on clinical outcomes.
This study aimed to elucidate the effects of concomitant sarcopenia and undernutrition on clinical outcomes in patients undergoing hemodialysis.
This prospective cohort study recruited outpatients undergoing hemodialysis from four facilities. Sarcopenia was diagnosed according to the criteria of the Asian Working Group for Sarcopenia, 2019. Undernutrition was determined using the Geriatric Nutritional Risk Index, with a score of |
| doi_str_mv | 10.1016/j.clnesp.2024.07.1059 |
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This study aimed to elucidate the effects of concomitant sarcopenia and undernutrition on clinical outcomes in patients undergoing hemodialysis.
This prospective cohort study recruited outpatients undergoing hemodialysis from four facilities. Sarcopenia was diagnosed according to the criteria of the Asian Working Group for Sarcopenia, 2019. Undernutrition was determined using the Geriatric Nutritional Risk Index, with a score of <92 classified as undernutrition. Patients were classified into four groups according to the presence or absence of sarcopenia and undernutrition. Cox proportional hazards analysis was used to assess the independent association between concomitant sarcopenia and undernutrition, all-cause mortality, and cardiovascular (CV) events after adjusting for baseline characteristics.
We included 450 patients in this analysis. Of the 450 patients, 69 (15.3%) had concomitant sarcopenia and undernutrition. The mean follow-up period was 1067 days, and there were 61 deaths and 60 CV events. The cumulative survival rate was significantly lower in the sarcopenia with undernutrition group (P = 0.011). The overlap of sarcopenia and undernutrition was significantly associated with a risk of mortality (hazard ratio 2.10; 95% confidence interval 1.05–4.21; P = 0.037). However, no association was observed between the co-occurrence of sarcopenia and undernutrition and the risk of CV events.
Concomitant sarcopenia and undernutrition were significantly associated with an increased mortality risk among patients undergoing hemodialysis. This finding reaffirms the importance of managing sarcopenia and undernutrition in patients undergoing hemodialysis in daily clinical practice.</description><identifier>ISSN: 2405-4577</identifier><identifier>EISSN: 2405-4577</identifier><identifier>DOI: 10.1016/j.clnesp.2024.07.1059</identifier><identifier>PMID: 39098604</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>clinical nutrition ; cohort studies ; Concomitant ; confidence interval ; Frailty cycle ; hazard ratio ; Hemodialysis ; malnutrition ; Mortality ; nutrition risk assessment ; risk ; Sarcopenia ; survival rate ; Undernutrition</subject><ispartof>Clinical nutrition ESPEN, 2024-10, Vol.63, p.651-658</ispartof><rights>2024 European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c276t-d019a2bb60757a5a3b23026d9a88705ade73eec335aa6126482d0d832f4b23133</cites><orcidid>0000-0003-0190-707X ; 0000-0002-9912-207X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39098604$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsujimoto, Naoyuki</creatorcontrib><creatorcontrib>Matsuzawa, Ryota</creatorcontrib><creatorcontrib>Kakita, Daisuke</creatorcontrib><creatorcontrib>Imai, Hiroto</creatorcontrib><creatorcontrib>Harada, Manae</creatorcontrib><creatorcontrib>Yoshikoshi, Shun</creatorcontrib><creatorcontrib>Yamabe, Sachi</creatorcontrib><creatorcontrib>Osada, Shiwori</creatorcontrib><creatorcontrib>Shimokado, Kiyoshi</creatorcontrib><creatorcontrib>Matsunaga, Atsuhiko</creatorcontrib><creatorcontrib>Tamaki, Akira</creatorcontrib><title>Concomitant sarcopenia and undernutrition: Impact on clinical outcomes in patients undergoing hemodialysis</title><title>Clinical nutrition ESPEN</title><addtitle>Clin Nutr ESPEN</addtitle><description>Sarcopenia and undernutrition are crucial in the cycle of frailty in patients requiring hemodialysis therapy, and their deleterious clinical consequences are well documented. However, little attention has been directed towards examining their combined impact on clinical outcomes.
This study aimed to elucidate the effects of concomitant sarcopenia and undernutrition on clinical outcomes in patients undergoing hemodialysis.
This prospective cohort study recruited outpatients undergoing hemodialysis from four facilities. Sarcopenia was diagnosed according to the criteria of the Asian Working Group for Sarcopenia, 2019. Undernutrition was determined using the Geriatric Nutritional Risk Index, with a score of <92 classified as undernutrition. Patients were classified into four groups according to the presence or absence of sarcopenia and undernutrition. Cox proportional hazards analysis was used to assess the independent association between concomitant sarcopenia and undernutrition, all-cause mortality, and cardiovascular (CV) events after adjusting for baseline characteristics.
We included 450 patients in this analysis. Of the 450 patients, 69 (15.3%) had concomitant sarcopenia and undernutrition. The mean follow-up period was 1067 days, and there were 61 deaths and 60 CV events. The cumulative survival rate was significantly lower in the sarcopenia with undernutrition group (P = 0.011). The overlap of sarcopenia and undernutrition was significantly associated with a risk of mortality (hazard ratio 2.10; 95% confidence interval 1.05–4.21; P = 0.037). However, no association was observed between the co-occurrence of sarcopenia and undernutrition and the risk of CV events.
Concomitant sarcopenia and undernutrition were significantly associated with an increased mortality risk among patients undergoing hemodialysis. This finding reaffirms the importance of managing sarcopenia and undernutrition in patients undergoing hemodialysis in daily clinical practice.</description><subject>clinical nutrition</subject><subject>cohort studies</subject><subject>Concomitant</subject><subject>confidence interval</subject><subject>Frailty cycle</subject><subject>hazard ratio</subject><subject>Hemodialysis</subject><subject>malnutrition</subject><subject>Mortality</subject><subject>nutrition risk assessment</subject><subject>risk</subject><subject>Sarcopenia</subject><subject>survival rate</subject><subject>Undernutrition</subject><issn>2405-4577</issn><issn>2405-4577</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkcFq3DAQQEVpaEKaT2jRsZfdjCTLsnspZWmTQKCX5ixmpdlUiy25klzI39eL05JbThLiPQ3MY-yDgK0A0V4ft26IVKatBNlswSyvun_DLmQDetNoY96-uJ-zq1KOAIvY942Ad-xc9dB3LTQX7LhL0aUxVIyVF8wuTRQDcoyez9FTjnPNoYYUP_O7cUJXeYrcDSEGhwNPc11sKjxEPmENFGtZvccU4iP_RWPyAYenEsp7dnbAodDV83nJHr5_-7m73dz_uLnbfb3fOGnauvEgepT7fQtGG9So9lKBbH2PXWdAoyejiJxSGrEVsm066cF3Sh6ahRRKXbJP679TTr9nKtWOoTgaBoyU5mKV0MqAanX3Ogpdp3Ujdb-gekVdTqVkOtgphxHzkxVgT1Hs0a5R7CmKBWNPURbv4_OIeT-S_2_9S7AAX1aAlp38CZRtccseHfmQyVXrU3hlxF_PmqC6</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Tsujimoto, Naoyuki</creator><creator>Matsuzawa, Ryota</creator><creator>Kakita, Daisuke</creator><creator>Imai, Hiroto</creator><creator>Harada, Manae</creator><creator>Yoshikoshi, Shun</creator><creator>Yamabe, Sachi</creator><creator>Osada, Shiwori</creator><creator>Shimokado, Kiyoshi</creator><creator>Matsunaga, Atsuhiko</creator><creator>Tamaki, Akira</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope><orcidid>https://orcid.org/0000-0003-0190-707X</orcidid><orcidid>https://orcid.org/0000-0002-9912-207X</orcidid></search><sort><creationdate>20241001</creationdate><title>Concomitant sarcopenia and undernutrition: Impact on clinical outcomes in patients undergoing hemodialysis</title><author>Tsujimoto, Naoyuki ; Matsuzawa, Ryota ; Kakita, Daisuke ; Imai, Hiroto ; Harada, Manae ; Yoshikoshi, Shun ; Yamabe, Sachi ; Osada, Shiwori ; Shimokado, Kiyoshi ; Matsunaga, Atsuhiko ; Tamaki, Akira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c276t-d019a2bb60757a5a3b23026d9a88705ade73eec335aa6126482d0d832f4b23133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>clinical nutrition</topic><topic>cohort studies</topic><topic>Concomitant</topic><topic>confidence interval</topic><topic>Frailty cycle</topic><topic>hazard ratio</topic><topic>Hemodialysis</topic><topic>malnutrition</topic><topic>Mortality</topic><topic>nutrition risk assessment</topic><topic>risk</topic><topic>Sarcopenia</topic><topic>survival rate</topic><topic>Undernutrition</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsujimoto, Naoyuki</creatorcontrib><creatorcontrib>Matsuzawa, Ryota</creatorcontrib><creatorcontrib>Kakita, Daisuke</creatorcontrib><creatorcontrib>Imai, Hiroto</creatorcontrib><creatorcontrib>Harada, Manae</creatorcontrib><creatorcontrib>Yoshikoshi, Shun</creatorcontrib><creatorcontrib>Yamabe, Sachi</creatorcontrib><creatorcontrib>Osada, Shiwori</creatorcontrib><creatorcontrib>Shimokado, Kiyoshi</creatorcontrib><creatorcontrib>Matsunaga, Atsuhiko</creatorcontrib><creatorcontrib>Tamaki, Akira</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><jtitle>Clinical nutrition ESPEN</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsujimoto, Naoyuki</au><au>Matsuzawa, Ryota</au><au>Kakita, Daisuke</au><au>Imai, Hiroto</au><au>Harada, Manae</au><au>Yoshikoshi, Shun</au><au>Yamabe, Sachi</au><au>Osada, Shiwori</au><au>Shimokado, Kiyoshi</au><au>Matsunaga, Atsuhiko</au><au>Tamaki, Akira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concomitant sarcopenia and undernutrition: Impact on clinical outcomes in patients undergoing hemodialysis</atitle><jtitle>Clinical nutrition ESPEN</jtitle><addtitle>Clin Nutr ESPEN</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>63</volume><spage>651</spage><epage>658</epage><pages>651-658</pages><issn>2405-4577</issn><eissn>2405-4577</eissn><abstract>Sarcopenia and undernutrition are crucial in the cycle of frailty in patients requiring hemodialysis therapy, and their deleterious clinical consequences are well documented. However, little attention has been directed towards examining their combined impact on clinical outcomes.
This study aimed to elucidate the effects of concomitant sarcopenia and undernutrition on clinical outcomes in patients undergoing hemodialysis.
This prospective cohort study recruited outpatients undergoing hemodialysis from four facilities. Sarcopenia was diagnosed according to the criteria of the Asian Working Group for Sarcopenia, 2019. Undernutrition was determined using the Geriatric Nutritional Risk Index, with a score of <92 classified as undernutrition. Patients were classified into four groups according to the presence or absence of sarcopenia and undernutrition. Cox proportional hazards analysis was used to assess the independent association between concomitant sarcopenia and undernutrition, all-cause mortality, and cardiovascular (CV) events after adjusting for baseline characteristics.
We included 450 patients in this analysis. Of the 450 patients, 69 (15.3%) had concomitant sarcopenia and undernutrition. The mean follow-up period was 1067 days, and there were 61 deaths and 60 CV events. The cumulative survival rate was significantly lower in the sarcopenia with undernutrition group (P = 0.011). The overlap of sarcopenia and undernutrition was significantly associated with a risk of mortality (hazard ratio 2.10; 95% confidence interval 1.05–4.21; P = 0.037). However, no association was observed between the co-occurrence of sarcopenia and undernutrition and the risk of CV events.
Concomitant sarcopenia and undernutrition were significantly associated with an increased mortality risk among patients undergoing hemodialysis. This finding reaffirms the importance of managing sarcopenia and undernutrition in patients undergoing hemodialysis in daily clinical practice.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>39098604</pmid><doi>10.1016/j.clnesp.2024.07.1059</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0190-707X</orcidid><orcidid>https://orcid.org/0000-0002-9912-207X</orcidid></addata></record> |
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| subjects | clinical nutrition cohort studies Concomitant confidence interval Frailty cycle hazard ratio Hemodialysis malnutrition Mortality nutrition risk assessment risk Sarcopenia survival rate Undernutrition |
| title | Concomitant sarcopenia and undernutrition: Impact on clinical outcomes in patients undergoing hemodialysis |
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