MO906DIAGNOSIS OF SARCOPENIA ACCORDING TO THE EWGSOP2 STEPS IN VERY ELDERLY HEMODIALYSIS PATIENTS

Abstract

\n \n \n Sarcopenia, defined as the loss of muscle mass and strength, is common in patients with chronic kidney disease. The variability of the prevalence of sarcopenia depends in part on the diagnostic criteria applied. In 2019, the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) proposed four steps to diagnose and assess sarcopenia. The concept of sarcopenia is encompassed within the broader concept of frailty.\n The aim of this study was to analyse the incidence of sarcopenia in very elderly patients on haemodialysis following the criteria recently established by the European Working Group on Sarcopenia in Older People EWGSOP2. Additionally, to assess the usefulness of the diagnostic algorithm in the very elderly haemodialysis population, and its association with functionally scales related to sarcopenia, such as dependency, frailty, and nutrition.\n \n \n \n In a prospective study of 60 patients on chronic hemodialysis aged 75- to 95-years, sarcopenia was assessed according to the 4 EWGSOP2 steps: Find-Assess-Confirm-Severity, using Strength, Assistance walking, Rise from a chair, Climb stairs, and Falls (SARC-F) to find, grip strength by dynamometry (GFD) and sit to stand to sit 5 (STS5) test to assess, appendicular skeletal muscle mass by bioimpedance to confirm and gait speed, the Timed-Up and Go (TUG) test, and the Short Physical Performance Battery (SPPB) for severity. Functionality scales of malnutrition inflammation (MIS), comorbility of Charlson, dependence of Barthel, fragility by FRAIL index2 and Physical Activity Scale for the Elderly (PASE) were conducted.\n \n \n \n Sixty patients were involved in the study. Sixty-eight percent (41) were men, with a mean age of 81.85±5.58 years and length of stay in HD 49.88±40.29 months. The sequential four steps resulted in a prevalence of confirmed sarcopenia of 20% and of severe sarcopenia of 20%. Correlation of the different variables defined by the EWGSOP2 with the scales of MIS, Barthel, Frail, Charlson and PASE was analyzed. It is observed that the SARC-F but not BIA correlates with the functionality tests. The GFD is the test that correlates with more variables, both functional and anthropometric. Of the severity measurement scales, the SPPB is the one that correlates with the greatest number of variables.\n \n \n \n These findings question the four-step EWGSOP2 assessment for very elderly hemodialysis patients and suggest that 20% had confirmed severe sarcopenia. Functionality scales correlated better with GFD and SPPB.\n