Objective: Sarcopenia is highly prevalent among haemodialysis (HD) patients and has been linked to higher mortality in this group. In the general population, especially in geriatric individuals, it has been linked to arterial hypertension (AH). Less is known about the connection between blood pressure (BP) and sarcopenia in the HD population. Design and method: A single-centre observational study was conducted among adult patients on chronic HD. Patients with active infection, malignancy, or prior limb amputations were excluded. Pre-dialysis BP measurement, pulse wave analysis, hand-grip strength, thigh ultrasound, and a sit-to-stand test (STST) were assessed. Statistical analysis was performed using commercially available SPSS® (version 31.0, Chicago, IL, USA). Results: Thirty-two HD patients were included in the analysis (37.5% female), with a mean age of 64.4 ± 17.7 years. The median dialysis vintage was 60.5 months (IQR 69.75). The most common causes for end-stage kidney disease were AH and diabetes mellitus (7 patients each). A positive correlation was found between pre-dialysis peripheral systolic BP and STST (R=0.458; p=0.037); between central diastolic BP and STST (R=0.591; p=0.006), and between central diastolic BP and m. vastus intermedius thickness on both legs (R=0.421; p=0.023 and R=0.488; p=0.007). Mean arterial pressure (MAP) positively correlated with STST (R=0.497; p=0.030). On the other hand, negative correlation was found between markers of arterial stiffness and sarcopenia markers – between augmented pressure (AP) and fist squeeze (R=-0.373; p=0.043) and STST (R=-0.480; p=0.032); between augmentation index (AIx) and fist squeeze (R=-0.376; p=0.040) and STST (R=-0.572; p=0.008); and between augmentation index normalized to heart rate 75/minute (AIx75) and fist squeeze (R=-0.460; p=0.011) and STST (R=-0.570; p=0.009). No correlation was found between sarcopenia markers and pre-dialysis peripheral diastolic BP, central systolic BP, or pulse pressure. Conclusions: The findings indicate that in chronic HD patients, greater muscle mass and functional performance are associated with higher peripheral systolic BP, central diastolic BP, and MAP, whereas increased arterial wave reflection and central pressure augmentation are linked to reduced physical performance, supporting a role of vascular dysfunction in the development of sarcopenia.
Varda et al. (Fri,) studied this question.