Using a generic definition of cachexia in patients with kidney disease receiving haemodialysis: a longitudinal (pilot) study

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2021-09, Vol.36 (10), p.1919-1926
• Main Authors: McKeaveney, Clare, Slee, Adrian, Adamson, Gary, Davenport, Andrew, Farrington, Ken, Fouque, Denis, Kalantar-Zadeh, Kamyar, Mallett, John, Maxwell, Alexander P, Mullan, Robert, Noble, Helen, O’Donoghue, Donal, Porter, Sam, Seres, David S, Shields, Joanne, Witham, Miles, Reid, Joanne
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cachexia - diagnosis; Cachexia - etiology; Female; Hand Strength; Humans; Kidney Diseases - therapy; Life Sciences; Longitudinal Studies; Male; Middle Aged; Renal Dialysis - adverse effects
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfaa174

Abstract Background Research indicates that cachexia is common among persons with chronic illnesses and is associated with increased morbidity and mortality. However, there continues to be an absence of a uniformed disease-specific definition for cachexia in chronic kidney disease (CKD) patient populations. Objective The primary objective was to identify cachexia in patients receiving haemodialysis (HD) using a generic definition and then follow up on these patients for 12 months. Method This was a longitudinal study of adult chronic HD patients attending two hospital HD units in the UK. Multiple measures relevant to cachexia, including body mass index (BMI), muscle mass [mid-upper arm muscle circumference (MUAMC)], handgrip strength (HGS), fatigue [Functional Assessment of Chronic Illness Therapy (FACIT)], appetite [Functional Assessment of Anorexia/Cachexia Therapy (FAACT)] and biomarkers [C-reactive protein (CRP), serum albumin, haemoglobin and erythropoietin resistance index (ERI)] were recorded. Baseline analysis included group differences analysed using an independent t-test, dichotomized values using the χ2 test and prevalence were reported using the Statistical Package for the Social Sciences 24 (IBM, Armonk, NY, USA). Longitudinal analysis was conducted using repeated measures analysis. Results A total of 106 patients (30 females and 76 males) were recruited with a mean age of 67.6 years [standard deviation (SD) 13.18] and dialysis vintage of 4.92 years (SD 6.12). At baseline, 17 patients were identified as cachectic, having had reported weight loss (e.g. >5% for >6 months) or BMI