Yamamoto S1, Matsuzawa R2, Harada M1, Watanabe T1, Shimoda T1, Suzuki Y1, Imamura K1, Isobe Y1, Kamiya K1, Osada S3, Yoshida A4, Matsunaga A1
1Kitasato University Graduate School of Medical Sciences, Rehabilitation Sciences, Sagamihara, Japan, 2Kitasato University Hospital, Rehabilitation, Sagamihara, Japan, 3Tokyo Ayase Kidney Center, Nephrology, Tokyo, Japan, 4Sagami Circulatory Organ Clinic, Hemodialysis Center, Sagamihara, Japan
Background: The SARC-F questionnaire is a simple tool for rapidly assessing physical function and screening for sarcopenia. However, the association between SARC-F and physical function in patients receiving hemodialysis has not been elucidated.
Purpose: The present study aimed to determine whether SARC-F is useful in screening for impaired physical function and in identifying the risk of physical limitations in patients receiving hemodialysis.
Methods: This cross-sectional study included 281 Japanese patients who were undergoing hemodialysis at two dialysis units. Information on demographic factors (age, sex, body mass index, time on hemodialysis), primary kidney disease, comorbid conditions, and biochemical variables was collected from medical records at each patient's entry into the study. SARC-F, handgrip strength, leg strength, one-leg standing time, usual gait speed, and Short Physical Performance Battery (SPPB) score were measured. SARC-F is a self-administered questionnaire that has five components: strength, assistance in walking, rise from a chair, climb stairs, and falls. It has a 3-level scoring system based on the level of difficulty, ranging from 0 (none) to 2 (a lot), for each component. Total score ranges from 0 to 10, with scores of ≥ 4 points indicating a risk of sarcopenia. Patients in this study were classified into two groups: SARC-F 4 and SARC-F ≥ 4. Furthermore, we defined physical limitations as handgrip strength of 26 kg for males and 18 kg for females, leg strength of 40%, usual gait speed of ≤ 0.8 m/s, and SPPB score of ≤ 8 points. To calculate the areas under the curves (AUCs) of SARC-F score for physical limitations, receiver-operating characteristic curve analysis was performed.
Results: Mean age of the study population was 67 ± 12 years, 59% of the patients were men, and the median time on hemodialysis was 7.1 (2.7-13.3) years. SARC-F of ≥ 4 points was observed in 75 (26.7%) patients receiving hemodialysis. The SARC-F ≥ 4 group had significantly lower handgrip strength and leg strength, poorer one-leg standing time, slower usual gait speed, and lower SPPB score than the SARC-F 4 group, even after adjusting for any potential confounders (P 0.001). Further, SARC-F demonstrated good accuracy in identifying the risk of physical limitations (all AUCs > 0.75).
Conclusion(s): SARC-F questionnaire is a useful tool in screening for impaired physical function and in identifying the risk of physical limitations in patients receiving hemodialysis.
Implications: These results support the usefulness of SARC-F, which can be easily and rapidly administered in clinical practice, among patients receiving hemodialysis.
Keywords: sarcopenia, physical function, hemodialysis
Funding acknowledgements: This work was supported by JSPS KAKENHI Grant Number JP26350631.
Purpose: The present study aimed to determine whether SARC-F is useful in screening for impaired physical function and in identifying the risk of physical limitations in patients receiving hemodialysis.
Methods: This cross-sectional study included 281 Japanese patients who were undergoing hemodialysis at two dialysis units. Information on demographic factors (age, sex, body mass index, time on hemodialysis), primary kidney disease, comorbid conditions, and biochemical variables was collected from medical records at each patient's entry into the study. SARC-F, handgrip strength, leg strength, one-leg standing time, usual gait speed, and Short Physical Performance Battery (SPPB) score were measured. SARC-F is a self-administered questionnaire that has five components: strength, assistance in walking, rise from a chair, climb stairs, and falls. It has a 3-level scoring system based on the level of difficulty, ranging from 0 (none) to 2 (a lot), for each component. Total score ranges from 0 to 10, with scores of ≥ 4 points indicating a risk of sarcopenia. Patients in this study were classified into two groups: SARC-F 4 and SARC-F ≥ 4. Furthermore, we defined physical limitations as handgrip strength of 26 kg for males and 18 kg for females, leg strength of 40%, usual gait speed of ≤ 0.8 m/s, and SPPB score of ≤ 8 points. To calculate the areas under the curves (AUCs) of SARC-F score for physical limitations, receiver-operating characteristic curve analysis was performed.
Results: Mean age of the study population was 67 ± 12 years, 59% of the patients were men, and the median time on hemodialysis was 7.1 (2.7-13.3) years. SARC-F of ≥ 4 points was observed in 75 (26.7%) patients receiving hemodialysis. The SARC-F ≥ 4 group had significantly lower handgrip strength and leg strength, poorer one-leg standing time, slower usual gait speed, and lower SPPB score than the SARC-F 4 group, even after adjusting for any potential confounders (P 0.001). Further, SARC-F demonstrated good accuracy in identifying the risk of physical limitations (all AUCs > 0.75).
Conclusion(s): SARC-F questionnaire is a useful tool in screening for impaired physical function and in identifying the risk of physical limitations in patients receiving hemodialysis.
Implications: These results support the usefulness of SARC-F, which can be easily and rapidly administered in clinical practice, among patients receiving hemodialysis.
Keywords: sarcopenia, physical function, hemodialysis
Funding acknowledgements: This work was supported by JSPS KAKENHI Grant Number JP26350631.
Topic: Musculoskeletal; Disability & rehabilitation; Outcome measurement
Ethics approval required: Yes
Institution: Kitasato University
Ethics committee: Allied Health Sciences Research Ethics Committee
Ethics number: 2015-033
All authors, affiliations and abstracts have been published as submitted.
