The Effect of Hemodialysis Treatment on Sarcopenia in Patients Newly Starting Hemodialysis

ABSTRACT Background The research aimed to establish sarcopenia occurrence rates among patients beginning hemodialysis treatment and assess muscle mass and function changes and sarcopenia status after six months of dialysis. Methods The prospective observational study included 110 patients who were new to hemodialysis (maximum 1 month). Patients were grouped as sarcopenic ( n  = 33) and non‐sarcopenic ( n  = 77) according to EWGSOP2 criteria. Demographic characteristics, body composition by bioelectrical impedance analysis, hand grip strength, walking speed tests, and laboratory parameters were evaluated at baseline and at 6 months. Results At baseline, 30% of the patients were considered sarcopenic. After six months of hemodialysis, only 2 of 33 patients (6.1%) who were sarcopenic at baseline remained sarcopenic ( p  = 0.76). Skeletal Muscle Index (SMI) increased from 6.4 ± 1.0 kg/m 2 to 6.9 ± 0.9 kg/m 2 in the sarcopenic group ( p  = 0.65), but this difference was not significant when compared with the non‐sarcopenic group ( p  = 0.32). Walking speed time improved from 10.5 ± 3.8 s to 8.7 ± 3.3 s in the sarcopenic group and the difference between the groups was statistically significant ( p  = 0.03). Right hand grip strength increased from 20.8 ± 9.2 kg to 31.2 ± 7.8 kg ( p  = 0.68). In multivariate analysis, SMI (OR: 0.38, p  < 0.001) was significantly associated with sarcopenia, while age ( p  = 0.37), gender ( p  = 0.15), albumin ( p  = 0.62), and CRP ( p  = 0.82) were not significantly associated. Conclusions Patients who start hemodialysis have high rates of sarcopenia but have significant muscle mass and functional improvements during the first six months of effective hemodialysis treatment. The removal of uremic toxins produces beneficial effects on muscle metabolism according to these results.