Malnutrition and Inflammation in Sarcopenia among Kidney Failure Patients on Maintenance Hemodialysis: Analysis of Serum Albumin and Neopterin

<ns5:p> Introduction Chronic kidney disease (CKD) affects more than 10% of the global population. Sarcopenia is a prevalent complication in CKD, especially in kidney failure patients undergoing maintenance hemodialysis (MHD), contributing to disability, hospitalization, and mortality. Multiple factors can cause sarcopenia in this population, including malnutrition and inflammation. Albumin is a well-established nutritional marker of malnutrition, while neopterin, an immune activation marker of malnutrition, has never been studied in sarcopenia in this population. Methods We conducted a cross-sectional study among adult kidney failure patients undergoing MHD. Serum albumin and neopterin were examined as biomarkers of malnutrition and inflammation alongside demographic and clinical data that also serve as risk factors. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia-2 (AWGS-2) criteria, using a bioelectrical impedance analyser (BIA), handgrip strength (HGS), and the 6-meter walk test. Statistical analyses included bivariate correlations and multivariate classification and regression trees (CART) analysis <ns5:bold>.</ns5:bold> Results The incidence of sarcopenia among 88 kidney failure patients undergoing MHD was quite high, affecting 52 subjects (59%), and 29 subjects (33%) were classified as severe sarcopenia. Albumin and neopterin, as biomarkers of malnutrition and inflammation, remain important variables in the incidence (accuracy 87.5%, area under the curve (AUC) 91.83%) and severity (accuracy 88.46%, AUC 91.83%) of sarcopenia among kidney failure patients undergoing MHD in multivariate analysis using classification and regression trees (CART). Conclusions Low serum albumin indicated malnutrition, and high serum neopterin indicated inflammation, becoming a potential biomarker in the incidence and severity of sarcopenia among kidney failure patients undergoing MHD. </ns5:p>