The role of sarcopenia in all-cause mortality prediction among community-dwelling adults with eGFR 15-89 mL/min/1.73 m

Objectives: Sarcopenia is common among individuals with impaired kidney function and is associated with poor quality of life and adverse clinical outcomes. This study aimed to investigate the association between sarcopenia and all-cause mortality among Chinese community-dwelling middle-aged and older adults with an estimated glomerular filtration rate (eGFR) of 15-89 mL/min/1.73 m Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), we included 2,526 participants aged 45-85 years with an eGFR of 15-89 mL/min/1.73 m Results: Among the 2,526 participants included in the final analysis, the prevalence of sarcopenia was 28.1 % (335/1,194) in men and 41.4 % (551/1,332) in women. After adjustment for potential confounders, sarcopenia was associated with a significantly higher risk of all-cause mortality in women (HR, 1.82; 95 % CI, 1.26-2.63). In exploratory analyses, the addition of sarcopenia to the clinical variable-based model modestly improved 5-year mortality risk discrimination in women, increasing the time-dependent AUC from 0.615 (95 % CI, 0.561-0.670) to 0.650 (95 % CI, 0.599-0.700). The IDI was 0.008 (95 % CI, 0.003-0.014; p=0.006), whereas the continuous NRI was 0.236 (95 % CI, -0.055-0.417; p=0.090). Conclusions: Sarcopenia was associated with an increased risk of all-cause mortality among women with an eGFR of 15-89 mL/min/1.73 m