Associação da sarcopenia com ativação do paciente com doença renal crônica em hemodiálise

Abstract

Introduction: Patient activation refers to the individual’s ability to understand their role in managing their own health care, encompassing knowledge, skills, and confidence for self-management. Sarcopenia is a muscle disorder that is common in patients undergoing hemodialysis and is characterized by reduced muscle mass and muscle strength or physical performance. As it is associated with a deterioration in overall patient status, such as physical limitations, reduced independence, poorer quality of life, and a higher incidence of falls and hospitalization, the presence of sarcopenia may be related to lower levels of patient activation in hemodialysis patients. Objective: To analyze the association between sarcopenia and patient activation in individuals undergoing hemodialysis. Methods: This cross-sectional study included patients aged ≥18 years who had been undergoing hemodialysis for at least three months. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) algorithm. Muscle strength was assessed using handgrip strength and the sit-to-stand test; lean mass was evaluated by bioelectrical impedance analysis; and physical performance was assessed using the Short Physical Performance Battery and gait speed. Patient activation was measured using the Patient Activation Measure-13 (PAM-13) questionnaire. Multivariable logistic regression models were used to evaluate the association between sarcopenia and patient activation. Results: A total of 79 patients were included; 55.7% were male, with a mean age of 58 ± 15 years. Most patients (81%) had high activation levels (PAM-13: 67.09 ± 15.32 points). The prevalence of sarcopenia ranged from 12.7% to 20.3%. There were no significant differences in muscle parameters, physical performance, or sarcopenia prevalence between the low and high activation groups. No significant association was found between the risk of sarcopenia, its components, or the diagnosis of probable and confirmed sarcopenia with activation level after adjustment for age, sex, and hemoglobin. Conclusion: No association was observed between sarcopenia and the patient’s level of activation in this sample of hemodialysis patients, suggesting that the relationship between the two may be mediated by other factors.