Agreement and reliability among muscle strength and physical performance assessments for sarcopenia diagnosis in patients on maintenance dialysis.

BACKGROUND

Screening and diagnosing sarcopenia is crucial in dialysis patients since sarcopenia has been associated with adverse outcomes in this population. However, the sarcopenia diagnosis may be different according to the strength or physical performance tests used for its diagnosis. Therefore, this study aimed to evaluate the agreement and reliability between different measures of muscle strength and physical performance in dialysis patients.

METHODS

Cross-sectional analysis by which patients on hemodialysis and peritoneal dialysis were enrolled. The sit-to-stand test and handgrip strength (HGS) were performed to evaluate muscle strength. The 4m-gait speed test and Short Physical Performance Battery (SPPB) were performed to evaluate physical performance. Low muscle strength and low physical performance were defined according to consensus from the European Working Group on Sarcopenia in Older People (EWGSOP2).

RESULTS

One-hundred ninety patients were enrolled, median age 58.5 (49.5-68.0), 57.4% male. HGS was negatively correlated with sit-to-stand test (r = -0.263; P = 0.001). Cohen kappa coefficient (κ) shows fair reliability between the classification of HGS (κ = 0.258; P < 0.001), and there was 60.0% of agreement. Gait speed was negatively correlated with SPPB score (r = -0.824; P < 0.001). There was moderate reliability between the classification of these tests (κ = 0.702; P < 0.001), with 85.3% of agreement.

CONCLUSION

There were differences in the classification of parameters of muscle strength and physical performance for sarcopenia diagnosis according to EWGSOP2 in maintenance dialysis patients, leading to variations in the prevalence of sarcopenia within the same criteria.