Banca de DEFESA: ANDREZA FERREIRA DA SILVA

Hemoglobin levels and risk of sarcopenia in patients undergoing treatment hemodialysis in the wild of Alagoas

hemodialysis, sarcopenia, hemoglobin levels.

Introduction: Anemia in Chronic Kidney Disease (CKD) results from insufficient production
of erythropoietin by the kidney and characteristic uremic metabolic changes. The chronic
anemic condition generates a decrease in the nutrition and oxygenation of the muscle tissue,
altering its functionality and contributing to sarcopenia, which can worsen the quality of life
and increase morbidity and mortality, making early detection essential for the initiation of
interventions. Objectives: To identify whether hemoglobin levels are associated with the risk
of sarcopenia in patients with chronic kidney disease on hemodialysis in the rural area of
Alagoas. Methods: Analytical cross-sectional study with individuals aged over 18 years with
CKD on hemodialysis at the hemodialysis service of Hospital Regional Santa Rita (HRSR) in
the city of Palmeira dos Índios and at the Hemodialysis and Hypertension Center Antonieta
Barreto do Centro Manoel André Hospital (CHAMA) in the city of Arapiraca. The study was
carried out in two stages: data collection from medical records (socioeconomic, demographic
and clinical), followed by the application of questionnaires (socioeconomic, demographic,
SARC-F and SARC-FP), nutritional and biochemical assessment. Data were tabulated in the
Excel® 2010 package and processed by IBM SPSS Software (Statistical Package for the
Social Sciences) version 26. Associations were made according to Pearson's chi-square test.
Results: 230 participants were included in the study, mostly elderly (55.7%), male (50.4%),
illiterate or with incomplete primary education (63.9%) and family income of less than two
minimum wages (91.3%). Predominantly diabetics (74.8%) with a risk of sarcopenia greater
than 50%. The Body Mass Index indicated eutrophy in 55.2% of the sample, followed by
malnutrition (32.6%) and overweight/obesity (12.2%). Arm circumference and calf
circumference indicated malnutrition in more than 50% of the sample. Hemoglobin showed
mean values of (10.4±0.12), hematocrit 32.14% (±0.33), creatinine, phosphorus, potassium,
calcium, pre-dialysis urea, post-dialysis urea respectively: (9, 95±0.15), (5.11±0.09),
(5.19±0.09), (7.46±0.10), (134.51±1.99) and (39, 55±1.13). The risk of sarcopenia was
positively associated with the Body Mass Index (p=0.008) and the KTV index (p=0.04).
Conclusion: Although hemoglobin levels did not show statistical significance with the risk of
sarcopenia, most patients had low hemoglobin levels. The limitation of the instrument used to

screen the risk of sarcopenia must be taken into account. On the other hand, variables such as
BMI and KTV showed statistically significant associations when analyzed with the risk of
sarcopenia. The socioeconomic factor of the region was presented as a potential influencer of
the profile found in the study indicating the need for adequate strategies and public policies
resulting in a decrease in public expenses involving the treatment of individuals since the state
of Alagoas has a precarious socioeconomic condition.