Abstract: Objective To analyze the prevalence and the risk factors for sarcopenia and sarcopenic obesity in patients undergoing maintenance hemodialysis (MHD).  Methods  A total of 107 patients undergoing MHD at the Department of Nephrology, Beijing Friendship Hospital, Capital Medical University from January 2023 to January 2024 were enrolled in this study. Univariate and multivariate regressions were conducted for the analysis of sarcopenia in MHD patients. Based on body fat percentage (≥30% for males and ≥ 40% for females), the patients were divided into sarcopenic obesity group and non-sarcopenic obesity group. Clinical data were compared between patient groups.  Results  The prevalence of sarcopenia in MHD patients was 33.6%. Compared to non-sarcopenia patients, the sarcopenia patients had older age (t=2.426, P=0.009), lower body mass index (BMI) (t=-3.541, P=0.001), higher prevalence rates of diabetes (χ²=4.466, P=0.035) and coronary artery disease (χ²=4.306, P=0.038), and higher modified quantitative subjective global assessment (MQSGA) scores (Z=-6.192, P＜0.001). Logistic regression showed that hemodialysis with diffusion and filtration (HDF) (OR=0.167, 95% CI:0.041～0.683, P=0.01) and higher BMI (OR=0.234, 95% CI: 0.074～0.736, P=0.013) were the protective factors against sarcopenia, while higher volume load (OR=4.951, 95% CI: 1.030～23.790, P=0.046) and higher MQSGA scores (OR=10.794, 95% CI: 3.060～38.071, P=0.000) were the risk factors for sarcopenia in MHD patients. The prevalence of sarcopenic obesity in MHD patients was 15.9%. Compared to non-sarcopenic obesity patients, the sarcopenia patients had a lower BMI (F=2.433, P=0.007), a higher body fat percentage (F=-5.661, P=0.007), a lower proportion of HDF (χ²=8.758, P=0.003), and a higher neutrophil to lymphocyte ratio (NLR) (F=-1.008, P=0.006).   Conclusion  The prevalence rates of sarcopenia and sarcopenic obesity are higher in MHD patients. Early identification and effective management of the abnormalities should be conducted for MHD patients with sarcopenia or sarcopenic obesity.

Key words: Maintenance hemodialysis patient, Body composition analysis, Sarcopenia, Sarcopenic obesity