Quality of life in patients with end-stage chronic kidney disease and sarcopenia

Aim. To perform a correlation analysis between QoL scales and diagnostic indicators of sarcopenia in CKD stage 5 (CKD5) patients, determined using bioimpedance spectroscopy (BIS) for body composition assessment. Materials and Methods. The study included 182 CKD5 patients residing in the Kemerovo Region. Sarcopenia was diagnosed in 56 patients according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. To assess QoL, we applied a dialysis-specific Kidney Disease Quality of Life Short Form ((KDQOL-SF) version 1.3 and sarcopenia-specific Sarcopenia Quality of Life (SarQoL) questionnaires. Results. In patients with sarcopenia and CKD5, the KDQOL-SF questionnaire showed low scores with regards to the following specific scales: CKD burden (60 [53.75; 70.0]), cognitive functions (61.1 [50.0; 66.67]), quality of social interaction (66.67 [55.56; 73.61]), quality of sleep (60.71 [57.14; 64.29]) and general perception of health (60 [50; 60]). The SarQoL questionnaire demonstrated low QoL scores in the following domains: physical and mental health (61 [54; 71]), locomotion (68 [65; 68]), body composition (45 [30; 45]), leisure activities (50 [50; 50]). A moderate and statistically significant positive correlation was identified between the Short Physical Performance Battery (SPPB) and the following domains: daily activities (r = 0.66), functionality (r = 0.72), body composition (r = 0.65), and physical and mental health (r = 0.66). Conclusion. Correlations were identified between SPPB scores and three specific scales of the KDQOL-SF questionnaire (symptoms/problems, cognitive function, and quality of social interaction), as well as five domains of the SarQoL questionnaire (leisure activities, activities of daily living, functionality, body composition, physical and mental health).

1. Yeo S.C., Wang H., Ang Y.G., Lim C.K., Ooi X.Y. Cost-effectiveness of screening for chronic kidney disease in the general adult population: a systematic review. Clin. Kidney J. 2023;17(1):sfad137. https://doi.org/10.1093/ckj/sfad137

2. Wilson S., Mone P., Jankauskas S.S., Gambardella J., Santulli G. Chronic kidney disease: Definition, updated epidemiology, staging, and mechanisms of increased cardiovascular risk. J. Clin. Hypertens (Greenwich). 2021;23(4):831-834. https://doi.org/10.1111/jch.14186

3. Morales A., William J.H. Chronic Dialysis Therapies. Adv. Kidney Dis. Health. 2024;31(6):553-565. https://doi.org/10.1053/j.akdh.2024.06.003

4. Robinson B.M., Akizawa T., Jager K.J., Kerr P.G., Saran R., Pisoni R.L. Factors affecting outcomes in patients reaching end-stage kidney disease worldwide: differences in access to renal replacement therapy, modality use, and haemodialysis practices. Lancet. 2016;388(10041):294-306. https://doi.org/10.1016/S0140-6736(16)30448-2

5. Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., Boirie Y., Cederholm T., Landi F., Martin F.C., Michel J.P., Rolland Y., Schneider S.M., Topinková E., Vandewoude M., Zamboni M.; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-423. https://doi.org/10.1093/ageing/afq034

6. Sanchez-Rodriguez D., Marco E., Cruz-Jentoft A.J. Defining sarcopenia: some caveats and challenges. Curr. Opin. Clin. Nutr. Metab. Care. 2020;23(2):127-132. https://doi.org/10.1097/MCO.0000000000000621

7. Ribeiro H.S., Neri S.G.R., Oliveira J.S., Bennett P.N., Viana J.L., Lima R.M. Association between sarcopenia and clinical outcomes in chronic kidney disease patients: A systematic review and metaanalysis. Clin. Nutr. 2022;41(5):1131-1140. https://doi.org/10.1016/j.clnu.2022.03.025

8. Liu T., Wu Y., Cao X., Yang K., Tong Y., Zhang F., Wang C., Cui R., Ren J., Li Q., Wang H., Liu C., Zhang J. Association between sarcopenia and new-onset chronic kidney disease among middle-aged and elder adults: findings from the China Health and Retirement Longitudinal Study. BMC Geriatr. 2024;24(1):134. https://doi.org/10.1186/s12877-024-04691-1

9. Shu X., Lin T., Wang H., Zhao Y., Jiang T., Peng X., Yue J. Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta-analysis. J. Cachexia Sarcopenia Muscle. 2022;13(1):145-158. https://doi.org/10.1002/jcsm.12890

10. Cruz-Jentoft A.J, Sayer A.A. Sarcopenia [published correction appears in Lancet. 2019;393(10191):2590. https://doi.org/10.1016/S0140-6736(19)31465-5]. Lancet. 2019;393(10191):2636-2646. https://doi.org/10.1016/S0140-6736(19)31138-9

11. Sayer A.A., Cruz-Jentoft A. Sarcopenia definition, diagnosis and treatment: consensus is growing. Age Ageing. 2022;51(10):afac220. https://doi.org/10.1093/ageing/afac220

12. Sharma S., Kalra D., Rashid I., Mehta S. Assessment of Health-Related Quality of Life in Chronic Kidney Disease Patients: A Hospital-Based Cross-Sectional Study. Medicina (Kaunas). 2023;59(10):1788. https://doi.org/10.3390/medicina59101788

13. Legrand K., Speyer E., Stengel B., Frimat L., Ngueyon Sime W., Massy Z.A., Fouque D., Laville M., Combe C., Jacquelinet C., Durand A.C., Edet S., Gentile S., Briançon S., Ayav C. Perceived Health and Quality of Life in Patients With CKD, Including Those With Kidney Failure: Findings From National Surveys in France. Am. J. Kidney Dis. 2020;75(6):868-878. https://doi.org/10.1053/j.ajkd.2019.08.026

14. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc. Sci. Med. 1995;41(10):1403-1409. https://doi.org/10.1016/0277-9536(95)00112-k

15. van Oevelen M, Bonenkamp A.A., van Eck van der Sluijs A., Bos W.J.W., Douma C.E., van Buren M., Meuleman Y., Dekker F.W., van Jaarsveld B.C., Abrahams A.C.; DOMESTICO study group. Health-related quality of life and symptom burden in patients on haemodialysis. Nephrol. Dial. Transplant. 2024;39(3):436-444. https://doi.org/10.1093/ndt/gfad179

16. Bahat G., Yilmaz O., Oren M.M., Karan M.A., Reginster J.Y., Bruyère O., Beaudart C. Cross-cultural adaptation and validation of the SARC-F to assess sarcopenia: methodological report from European Union Geriatric Medicine Society Sarcopenia Special Interest Group. Eur. Geriatr. Med. 2018;9(1):23-28. https://doi.org/10.1007/s41999-017-0003-5

17. Johansen K.L., Lee C. Body composition in chronic kidney disease. Curr. Opin. Nephrol. Hypertens. 2015;24(3):268-275. https://doi.org/10.1097/MNH.0000000000000120

18. Li Y., Xing T., Xu R., Liu Y., Zhong X., Liu Y., Tan R. Singlepool model urea clearance index is associated with sarcopenia and nutritional status in patients undergoing maintenance hemodialysis: a cross-sectional study. BMC Nephrol. 2024;25(1):80. https://doi.org/10.1186/s12882-024-03510-4

19. Yamada Y., Nishizawa M., Uchiyama T., Kasahara Y., Shindo M., Miyachi M., Tanaka S. Developing and Validating an Age-Independent Equation Using Multi-Frequency Bioelectrical Impedance Analysis for Estimation of Appendicular Skeletal Muscle Mass and Establishing a Cutoff for Sarcopenia. Int. J. Environ Res. Public Health. 2017;14(7):809. https://doi.org/10.3390/ijerph14070809

20. Vasilyeva IA, Smirnov AV. Assessment of the quality of life of patients on hemodialysis using the KDQOL-SFTM questionnaire. Nephrology. 2018;22(5):58-63. (In Russian). https://doi.org/10.24884/1561-6274-2018-22-5-58-63

21. Fletcher B.R., Damery S., Aiyegbusi O.L., Anderson N., Calvert M., Cockwell P., Ferguson J., Horton M., Paap M.C.S., Sidey-Gibbons C., Slade A., Turner N., Kyte D. Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLoS Med. 2022;19(4):e1003954. https://doi.org/10.1371/journal.pmed.1003954

22. Manfredini F., Mallamaci F., D'Arrigo G., Baggetta R., Bolignano D., Torino C., Lamberti N., Bertoli S., Ciurlino D., Rocca-Rey L., Barillà A., Battaglia Y., Rapanà R.M., Zuccalà A., Bonanno G., Fatuzzo P., Rapisarda F., Rastelli S., Fabrizi F., Messa P., De Paola L., Lombardi L., Cupisti A., Fuiano G., Lucisano G., Summaria C., Felisatti M., Pozzato E., Malagoni A.M., Castellino P., Aucella F., Abd ElHafeez S., Provenzano P.F., Tripepi G., Catizone L., Zoccali C. Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial. J. Am. Soc. Nephrol. 2017;28(4):1259-1268. https://doi.org/10.1681/ASN.2016030378

23. Gasparik A.I., Mihai G., Beaudart C., Bruyère O., Pop R.M., Reginster J.Y., Pascanu I.M. Correction to: Psychometric performance of the Romanian version of the SarQoL®, a health-related quality of life questionnaire for sarcopenia. Arch Osteoporos. 2018;13(1):98. https://doi.org/10.1007/s11657-018-0516-7

24. Lee H., Kim J. Evaluating the SarQoL® Questionnaire as a Screening Tool for Sarcopenia among Korean Older Adults. Healthcare (Basel). 2024;12(19):2000. https://doi.org/10.3390/healthcare12192000

25. Geerinck A., Locquet M., Bruyère O., Reginster J.Y., Beaudart C. Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL® questionnaire. J. Cachexia Sarcopenia Muscle. 2021;12(2):319-330. https://doi.org/10.1002/jcsm.12687