Nutritional intake adequacy, muscle mass, strength, and sarcopenia in adults on hemodialysis in Panama: A descriptive cross-sectional study.

BACKGROUND

Malnutrition and sarcopenia are highly prevalent among patients on hemodialysis, leading to reduced functional capacity, impaired quality of life, and increased mortality. Despite its relevance, nutritional and muscle health assessments remain limited in routine dialysis care, particularly in resource-limited health systems. Our study aimed to evaluate nutritional intake adequacy and muscle health indicators in adults receiving maintenance hemodialysis.

METHODS

We performed a descriptive cross-sectional study in 105 adults receiving maintenance hemodialysis (January-July 2025). Dietary intake was assessed with a single 24-h dietary recall. Muscle health was evaluated using skeletal muscle mass index, phase angle, calf circumference, and handgrip strength.

RESULTS

Median energy and protein intakes were 17.0 kcal/kg/day and 0.8 g/kg/day, with 89.5% and 79.0% of participants consuming <80% of requirements. Sarcopenia was present in 22.9% of participants (31.6% women vs. 17.9% men, p = 0.17) and was significantly associated with severely reduced body-mass-index-adjusted calf circumference (OR 7.1, 95% CI 2.3, 22.3). Calf circumference correlated positively with the skeletal muscle mass index (r = 0.37, p < 0.001). The standardized phase angle was low on 62.9% of participants, and significantly lower in those with sarcopenia [-3.3 (1.5) vs. -1.8 (2.5); p = 0.003], correlating with handgrip strength (r = 0.26, p = 0.009). Dialysis vintage was not associated with sarcopenia or dietary adequacy.

CONCLUSION

Hemodialysis patients in a Latin American public health setting showed markedly inadequate energy and protein intake, high prevalence of sarcopenia, and reduced phase angle. Routine assessment of muscle health may provide a feasible and comprehensive approach to guide nutritional interventions and improve outcomes.