Low Physical Activity is Strongly Associated with Sarcopenia in Indonesian Haemodialysis Patients

Abstract

Background: Sarcopenia is a clinically important complication of maintenance haemodialysis (MHD), but evidence on associated factors in Indonesian patients remains limited. This study aimed to identify the independent factors associated with sarcopenia in this population.
Methods: This multicentre cross-sectional study evaluated the proportion of sarcopenia and factors independently associated with it among 134 adults with end-stage kidney disease receiving MHD at three hospitals in Makassar, Indonesia. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria using appendicular skeletal muscle mass index measured by bioelectrical impedance analysis, handgrip strength, and physical performance. Physical activity was assessed using the International Physical Activity Questionnaire. Associations were examined using chi-square tests, followed by multivariable logistic regression for variables with p<0.25.
Results: Sarcopenia was present in 75 participants (56.0%), including 39 (29.1%) with severe sarcopenia. On multivariable analysis, low physical activity (OR 53.5, 95% CI 10.25–278.80; p<0.001), underweight status (OR 15.7, 95% CI 2.55–96.94; p=0.003), age ≥60 years (OR 4.2, 95% CI 1.35–12.89; p=0.013), and male sex
(OR 4.1, 95% CI 1.41–11.86; p=0.010) were independently associated with sarcopenia. Sarcopenia affected more than half of the studied MHD population.
Conclusions: Sarcopenia is highly prevalent among patients receiving maintenance haemodialysis in Makassar. Low physical activity emerged as the strongest independent risk factor, followed by other factors. Routine sarcopenia screening, physical activity assessment, and nutritional evaluation may help identify MHD patients who require targeted preventive and rehabilitative strategies.