Low muscle strength and self-reported fatigue in patients on hemodialysis: findings from the SARC-HD study

Low muscle strength and self-reported fatigue in patients on hemodialysis: findings from the SARC-HD study

BackgroundWhether low muscle strength contributes to fatigue remains poorly understood. We investigated the association between dynapenia and self-reported fatigue in patients on hemodialysis.MethodsA cross-sectional analysis of the multicenter SARC-HD study in 19 dialysis units across Brazil. Muscl...

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Main Authors: Marvery P. Duarte, Otávio T. Nóbrega, Maryanne Z. C. Silva, Dario R. Mondini, Bruna M. Sant'Helena, Daiana C. Bundchen, Maristela Bohlke, Angélica N. Adamoli, Ricardo M. Lima, Antônio Inda-Filho, João L. Viana, Barbara P. Vogt, Maycon M. Reboredo, Heitor S. Ribeiro, the SARC-HD Study Group, Fábio A. Vieira, Priscila M. Varela, Jacqueline S. Monteiro, Marina S. Pereira, Ana C. Bainha, Emanuele P. Gravina, Abner R. Castro, Fabiana L. Costa, Luiz R. Medina, Flávio I. Nishimaru, Maria G. Rosa, Ana C. Picinato, Marco C. Uchida, Karine Pires Costa, Beatriz R. Viana, Antônia S. Almeida, Ana C. Pires, Catiussa Colling, Aparecido P. Ferreira
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Nutrition
Subjects:
dialysis
fatigue
sarcopenia
muscle weakness
tiredness
Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1583976/full
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Summary:BackgroundWhether low muscle strength contributes to fatigue remains poorly understood. We investigated the association between dynapenia and self-reported fatigue in patients on hemodialysis.MethodsA cross-sectional analysis of the multicenter SARC-HD study in 19 dialysis units across Brazil. Muscle strength was evaluated by handgrip strength (HGS) and five times sit-to-stand (STS-5). Low muscle strength (i.e., dynapenia) was defined based on the revised EWGSOP. Patients were stratified into four dynapenia phenotypes (i) no dynapenia; (ii) low HGS; (iii) low STS-5; and (iv) severe dynapenia (low HGS and STS-5). From the validated 36-item short-form health survey (SF-36) question about tiredness, patients self-reported their frequency of fatigue as (i) Never or rarely; (ii) Sometimes; and (iii) Always or constantly.ResultsAmong 841 patients (58 ± 15 years, 38% female, and 49% Black), the prevalences of dynapenia by low HGS, low STS-5, and severe dynapenia were 13.9, 18.8, and 12.1%, respectively. Frequency of fatigue, self-reported as “Never or rarely,” “Sometimes” or “Always or constantly” was 39.5, 30.3, and 30.2%, respectively. The frequency of “Always or constantly” feeling fatigued was 24.2% among patients without dynapenia, 36.5% in dynapenia by low HGS, 37.2% in dynapenia by low STS-5, and 37.8% in severe dynapenia (p < 0.001). Adjusted logistic regressions showed a significant association between all dynapenia phenotypes and high frequency of fatigue compared to those without dynapenia (low HGS: odds ratio [OR] = 1.91; 95% confidence intervals [CI]: 1.12–3.23; low STS-5: OR = 2.35; 95%CI: 1.50–3.69; severe dynapenia: OR = 2.73; 95%CI: 1.55–4.81).ConclusionPatients on hemodialysis with low muscle strength were more likely to self-report a higher frequency of fatigue, independently of the dynapenia phenotype. This highlights the importance of recognizing low muscle strength as a potential contributor to fatigue in this population.
ISSN:2296-861X

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