The Japanese Journal of Clinical Dialysis Vol.33 No.8(8)

Theme Manifold preferable strategies for better prognosis of the dialysis patients
Title The approach how to prevent and improve frailty and sarcopenia in dialysis patients
Publish Date 2017/07
Author Akihiko Kato Blood Purification Unit, Hamamatsu University Hospital
[ Summary ] In an elderly society, dealing with frailty and sarcopenia early is vital. Manifestations of geriatric syndromes are recognized as being important to improve prognoses for dialysis patients. For early detection of frailty or sarcopenia, we first need to take an interest in both syndromes, and understand their diagnostic criteria. To diagnose sarcopenia, bioelectrical impedance assays or dual energy X-ray absorptiometry (DXA) are used to assess muscle mass volume. However, since measurement of muscle mass area at the third lumbar vertebra level on cross-sectional images of abdominal computed tomography (CT) can predict whole muscle mass volume in patients with chronic liver disease. This method may be applicable for the assessment of muscle mass volume in dialysis patients. Despite there being no consensus on diagnostic criteria for frailty world wide, the criteria for J-CHS or the "Kihon Checklist" developed by the Japanese Ministry of Health, Labor and Welfare can predict frailty in the elderly. Both nutrition and exercise intervention are required for the prevention and improvement of frailty or sarcopenia. Dialysis patients are required to consume adequate dietary protein, including branched chain amino acids, both on dialysis and non-dialysis days, In addition, weight training and aerobic exercise such as walking 3 to 4 times for a week are useful in preventing of sarcopenia.
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