| [ Summary ] |
As the Japanese guideline for sarcopenia and frailty, "Guidelines for the Management of Sarcopenia 2017" and "Clinical Guide for Frailty 2018" were published. It is recommended that the diagnosis of sarcopenia should be based on the criteria of Asian Working Group for Sarcopenia (AWGS), while physical frailty should be defined based on the criteria of Japanese version of Cardiovascular Health Study (J-CHS). In prevalent dialysis patients, physical functions, such as handgrip strength and usual walking speed, rather than skeletal muscle mass volume are more associated with survival prognosis. Therefore, as the home-based aerobic exercise, low- to moderate-intensity walks for 30 min for 4 to 7 days (mainly at non-dialysis day) a week are recommended for dialysis patients, and an initial goal recommended for the daily step count is 4,000. Protein-energy wasting (PEW) is diagnosed based on the definition of International Society of Renal Nutrition and Metabolism (ISRNM). However, this definition is not valid for Japanese dialysis patients; thus, a novel modified definition is required. |