SARCOPENIA was independently associated with a higher incidence of intradialytic hypotension (IDH) among patients receiving haemodialysis, according to a prospective cohort study involving 236 patients across two centres.
The study investigated the prevalence of sarcopenia among patients receiving haemodialysis and examined whether sarcopenia was independently associated with IDH. Participants were classified according to the 2019 Asian Working Group for Sarcopenia guidelines.
Skeletal muscle index (SMI) was assessed using bioimpedance analysis, while handgrip strength was measured with a dynamometer and gait speed was assessed using a 6 m walk. Patients were followed for 2 years, during which dialysis sessions, IDH events and clinical endpoints were recorded.
Sarcopenia was identified in 82 of the 236 participants, corresponding to a prevalence of 34.8%.
During the 2-year follow-up, 57,784 dialysis sessions were monitored, and 9,001 IDH events were recorded, representing 15.6% of all sessions.
Multivariate negative binomial regression analysis found that sarcopenia was independently associated with a higher incidence of IDH (incidence rate ratio (IRR): 1.69; 95% CI: 1.21–2.36; p=0.002).
Analysis of the individual components of sarcopenia also identified associations with IDH risk. Greater handgrip strength was associated with a lower incidence of IDH (IRR: 0.98; 95% CI: 0.97–1.00; p=0.034). Higher SMI was similarly associated with a reduced incidence of IDH (IRR: 0.86; 95% CI: 0.74–0.99; p=0.037).
Gait speed was not significantly associated with IDH (p=0.447).
The findings suggest that sarcopenia may represent an independent marker of IDH risk among patients receiving haemodialysis. The associations observed for SMI and handgrip strength indicate that measures of muscle health may have value in identifying patients at increased risk.
The researchers recommended screening skeletal muscle mass and handgrip strength to support early identification of patients at higher risk of IDH.
However, the findings do not establish whether treating sarcopenia could prevent IDH. Further interventional studies are required to determine whether targeted interventions for sarcopenia can reduce IDH episodes and improve clinical outcomes among patients receiving haemodialysis.
Reference
Yan M et al. Sarcopenia is independently associated with intradialytic hypotension: a prospective cohort study. Sci Rep. 2026;DOI:10.1038/s41598-026-70852-4.
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