Dr LIMY WONG1,2, Professor LAWRENCE P MCMAHON1,2
1Eastern Health, Box Hill, Australia, 2Monash University Eastern Health Clinical School, Box Hill, Australia
Biography:
Dr Limy Wong is a Nephrologist and Postdoctoral Fellow at Eastern Health. She graduated with First Class Honours in Medicine from the Royal College of Surgeons in Ireland and completed Nephrology specialist training in Ireland and the UK. She completed a Wellcome Trust Clinical PhD Fellowship at the University of Cambridge, studying the genetics of ANCA-associated vasculitis. She was awarded the 2021 and 2022 RACP Jacquot Research Establishment Fellowship, which support her current research focus in understanding the biological basis of sarcopenia in patients with chronic kidney disease and to determine the relationship between sarcopenia and renal osteodystrophy.
Aim:
This study explored the progression and potential reversibility of sarcopenia and frailty among patients on maintenance haemodialysis.
Background:
Sarcopenia, characterised by loss of muscle mass and strength, is a major component of frailty, and both syndromes are linked to higher risks of adverse health outcomes. Previous studies have mainly provided a static view, assessing these conditions at a single time point.
Methods:
In this prospective study, 81 patients were initially recruited from May 2021, with 60 completing a follow-up (62% male, mean age 74 years) after an average of 1.3 years. Frailty was measured using the Clinical Frailty Scale (CFS) and sarcopenia was assessed through bioelectrical impedance analysis, handgrip strength, and physical performance tests. No interventions were implemented during the study, and descriptive statistics were used for analysis.
Results:
At baseline, 37 patients were classified as non-frail (CFS <4). By the second visit, 73% remained non-frail, while 27% had transitioned to frailty. Of those initially frail, 83% remained frail, and 17% improved to a non-frail state. Regarding the grade of frailty severity, 52% stayed at the same grade, 37% worsened, and only 11% improved. Similarly, 42 patients were diagnosed with sarcopenia at baseline; 37 remained sarcopenic, while 5 showed improvement. Among the probable sarcopenic group, one-third either reverted to non-sarcopenic status or progressed to full sarcopenia. Of the 12 initially non-sarcopenic patients, six developed sarcopenia over time.
Conclusions:
The findings indicate that while sarcopenia and frailty status remain relatively stable in most haemodialysis patients, a notable proportion deteriorates and an even lesser number shows signs of improvement. Monitoring changes over time is crucial for early intervention and management strategies.
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