DAI Tingting 1 , ZENG Xiaoqing 2 , LIU Yuan 2 , GONG Jie 1 , ZHOU Li 3 , CHENG Yi 2 , CHEN Lin 4 , HU Wen 1,2
  • 1. West China School of Public Health / West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
  • 2. Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
  • 3. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
  • 4. Hemodialysis Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
HU Wen, Email: wendy_nutrition@163.com
Hemodialysis; Muscle loss; Bioelectric impedance; Body composition; Influencing factors
10.7507/1002-0179.201912065
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Objective To study the differences in body composition between maintenance hemodialysis (MHD) patients with reduced muscle mass and the ones with normal muscle mass by bioelectrical impedance analysis, and explore the influencing factors.Methods A total of 122 patients undergoing MHD in the hemodialysis center of a general hospital between September 2018 and May 2019 were selected as the research subjects. According to the relative skeletal muscle mass index, they were divided into the muscle loss group and the normal muscle mass group. Their general conditions, post-dialysis body composition, and serum albumin were collected to analyze the differences between the two groups, and a multiple stepwise logistic regression analysis was carried out.Results Among the included subjects, 53 patients had normal muscle mass and 69 patients had muscle mass loss. The post-dialysis body weight, muscle-related indexes, intracellular water, extracellular water (ECW), total body water (TBW), protein, minerals, body cell mass, bone mineral content, body mass index, arm circumference, and arm muscle circumference in the normal muscle mass group were higher than those in the muscle loss group (P<0.05); the percentage of ECW/TBW in the normal muscle mass group was lower than that in the muscle loss group (P<0.05). The multiple stepwise logistic regression analysis showed that the post-dialysis weight [odds ratio (OR)=0.679, 95% confidence interval (CI) (0.535, 0.862), P=0.001] was a protective factor from losing muscle in MHD patients, and the high ECW/TBW [OR=6.926, 95%CI (1.014, 47.280), P=0.048], low body cell mass [OR=57.707, 95%CI (6.927, 480.761), P<0.001], low bone mineral content [OR=9.743, 95%CI (1.220, 77.831, P=0.032], and arm circumference [OR=2.183, 95%CI (1.004, 4.749), P=0.049] were risk factors for muscle loss in MHD patients.Conclusions MHD patients have a high incidence of muscle loss. It is necessary to monitor the changes of their body composition, especially those who with low post-dialysis body weight, lack of bone minerals and body cells, excessive ECW/TBW, and increased arm circumference after hemodialysis. Both nutritional interventions and exercise interventions should be performed timely and routinely to prevent the occurrence of sarcopenia.

Citation： DAI Tingting, ZENG Xiaoqing, LIU Yuan, GONG Jie, ZHOU Li, CHENG Yi, CHEN Lin, HU Wen. Analysis of influencing factors of muscle loss in patients undergoing maintenance hemodialysis. West China Medical Journal, 2020, 35(4): 489-493. doi: 10.7507/1002-0179.201912065 Copy

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