Should We Use the SARC-F Score in Sarcopenia Screening in Kidney Transplant Patients?

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Mahmut Armagan, Nazife Nur Ozer Sensoy, Fatma Betul Guzel, Murat Sahin, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7321096/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Backgrounds The risk of sarcopenia is increased in kidney transplant (KT) patients. The SARC-F score is a reliable tool used for sarcopenia screening; however, it has not been tested in KT patients. Objective The aim of our study is to assess the prevalence of sarcopenia in KT recipients and to investigate the relationship between the SARC-F score and sarcopenia parameters. Methods The study included 150 KT patients. Body muscle mass was measured using the Tanita DC 360 ST device. Before these measurements, patients were scored using the five-question SARC-F assessment, and their scores were recorded. Results 28 patients were diagnosed with sarcopenia, yielding a sarcopenia prevalence of 22.9%. The mean age of the patients was 42 ± 13.5 years. Correlation analysis of SARC-F scoring results revealed a negative correlation between SARC-F and total muscle mass, muscle percentage, skeletal muscle mass, skeletal muscle index, grip strength, and walking speed parameters, as expected. Analysis of SARC-F scores showed that only 12 of the 150 patients had a SARC-F score greater than 4. Patients with SARC-F ≥ 4 had significantly lower musculoskeletal parameters (BMI, total muscle mass, skeletal muscle mass, and skeletal muscle index) compared to those with SARC-F < 4 (p < 0.0001). However, only one of these patients met the criteria for sarcopenia. Conclusion The findings of this study indicate that the SARC-F score is associated with muscle mass and strength parameters in KT patients and may be used as a screening tool. However, it is not sufficient as a standalone diagnostic tool for sarcopenia. Kidney transplantation SARC-F sarcopenia screening Figures Figure 1 Introduction Kidney transplantation improves survival and quality of life in patients with end-stage renal disease (ESRD) and is superior to dialysis therapy. Therefore, it has become the first-line treatment choice for ESRD management. The term sarcopenia was first introduced in 1989 to describe age-related loss of muscle mass. Despite decades since its initial definition, the concept and its clinical implications remain controversial [ 1 ]. To establish a standardized definition, the European Working Group on Sarcopenia in Older People (EWGSOP) was formed by the European Geriatric Society. This group has reported that sarcopenia may lead to reduced mobility, increased risk of falls and fractures, lower quality of life, and even mortality [ 1 ]. The clinical definition of sarcopenia is based on parameters such as body muscle mass, handgrip strength, and walking speed. However, assessing sarcopenia in clinical practice requires time and space. Therefore, an ideal screening tool should be simple, practical, and cost-effective. In this context, Malmstrom (2013) developed the SARC-F questionnaire, a rapid and easily applicable screening tool for clinical use [ 2 ]. Sarcopenia results in progressive loss of muscle strength and mass, and it may develop due to primary or secondary causes. Among the secondary causes, chronic kidney disease (CKD) and long-term glucocorticoid use are recognized contributors [ 3 ]. In CKD-related sarcopenia, the imbalance between anabolic and catabolic processes controlling muscle homeostasis plays a critical role. Metabolic acidosis and inflammation associated with CKD contribute to muscle strength loss from the early stages of conservative treatment [ 3 ]. Sarcopenia in CKD is strongly linked to increased morbidity, higher mortality, physical disability, and a greater risk of cardiovascular events [ 3 ]. In recent years, several studies have investigated sarcopenia in kidney transplant recipients; however, literature data remain insufficient. Studies evaluating sarcopenia prevalence in this population have reported wide variations due to differences in diagnostic criteria [ 4 ]. Research indicates that sarcopenia manifests at a younger age in kidney transplant recipients compared to the general population [ 5 , 6 ]. While some studies in CKD and other populations have demonstrated a strong association between SARC-F scores and sarcopenia [ 7 , 8 ], others have found it to be less predictive [ 8 ]. To date, no studies have evaluated the use of SARC-F scoring in kidney transplant patients. In this study, we aimed to investigate, for the first time in the literature, the relationship between SARC-F scores and sarcopenia parameters in kidney transplant recipients. Methodology This study is a cross-sectional case-control study conducted by the Department of Nephrology at Kahramanmaraş Sütcü Imam University Faculty of Medicine. Ethical approval was obtained from the KSU Ethics Committee (Decision No: 02) on 22/11/2022, and written informed consent was obtained from all participants before enrollment. The study included 150 kidney transplant recipients (97 males, 53 females) who were over 18 years of age and had undergone kidney transplantation at least three months prior. Patients were excluded if they were under 18 years old, had undergone transplantation less than three months prior, or had mobility impairments. Data Collection Demographic and clinical data, including age, sex, comorbid conditions (such as hypertension, diabetes mellitus, or coronary artery disease), etiology of CKD, duration of hemodialysis before transplantation, post-transplantation period, type of kidney transplant (living donor or cadaveric), and immunosuppressive medications, were collected from patient interviews and electronic medical records. Laboratory Analysis On the day of their follow-up visit, patients' laboratory parameters were retrieved from the hospital's electronic medical record system. These included: serum urea and creatinine (Cr), Sodium (Na), potassium (K), calcium (Ca), phosphorus (P) levels, low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels, serum albumin levels and spot urine protein and spot urine creatinine levels. Anthropometric Measurements Volunteers were taken to the measurement room on the day of their clinic visit. Handgrip strength was assessed using a Kyto digital hand dynamometer to evaluate muscle strength. The volunteers were first instructed on how to use the dynamometer. Measurements were then taken from the dominant upper extremity, and the highest value from three attempts was recorded. Muscle mass measurements were conducted using Bioelectrical Impedance Analysis (BIA), with the Tanita DC 360 ST body analysis device. BIA provided calculations of fat percentage, muscle percentage, mineral percentage, protein percentage, fluid ratio, fat-free mass, fat mass, muscle mass, bone mass, and skeletal muscle mass, which were recorded. For the assessment of walking speed, volunteers were asked to walk at their usual daily pace along a straight line marked on the floor of the measurement room. The obtained data were recorded in meters per second (m/s). The presence of sarcopenia was determined according to the 2018 EWGSOP criteria. SARC-F Scoring SARC-F evaluates muscle strength, walking ability, ability to rise from a chair, stair climbing, and the frequency of spontaneous falls. The five-question test assigns a score ranging from 0 to 2 for each question. A total score of 4 or higher is considered indicative of high sarcopenia risk, warranting further evaluation [ 12 ]. In our study, SARC-F scoring (Fig. 1 ) was calculated and recorded prior to anthropometric analysis. Statistical Analysis Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 27.0 (IBM Corp., Released 2020), and statistical significance was set at p < 0.05. Descriptive data were presented as count (n), percentage (%), mean (M), and standard deviation (SD). Kolmogorov-Smirnov and Shapiro-Wilk tests were used to assess normality of data distribution. For normally distributed data, comparisons between two groups were conducted using the Independent Samples T-test. For non-normally distributed data, the Mann-Whitney U test, a nonparametric alternative, was applied. For categorical data comparisons, the Chi-square test was used. Correlation analysis between SARC-F scores and demographic, laboratory, and musculoskeletal parameters was conducted using the Pearson and Spearman correlation tests. Results 1.General Population Demographics, Laboratory, and Musculoskeletal Findings : The study included 150 kidney transplant recipients, comprising 97 male patients (64.7%) and 53 female patients (35.3%). The mean age of the patients was 44.6 ± 11.5 years. Of the total participants, 110 patients (73.3%) underwent kidney transplantation from a living donor, while 40 patients (26.7%) received a cadaveric kidney transplant. The mean post-transplant period was 84.98 ± 53.2 months (Table 1 ). Table 1 General laboratory data of patients. Parameter Mean Value Age (Year) 44,6 ± 11,5(19–72) Total dialysis time (Year) 3,7 ± 4,9 (0–16) Kidney Transplant Duration (Month) 84,98 ± 53,2 (4-252) BUN (mg/dL) 19,9 ± 10,9 (8–79) Creatinine (mg/dL) 1,3 ± 0,7 (0.61-5,72) GFR (ml/dk) 67,3 ± 23,8 (11–127) Na (mEq/dL) 139,1 ± 2,7 (128–146) K (mEq/dL) 4,3 ± 0,48 (2,9 − 5,6) Ca (mg/dL) 9,9 ± 6,4 (6,5–11,4) P (mg/dL) 3,3 ± 0,75 (1,46 − 6,59) Albumin (mg/dL) 4,3 ± 0,35 (3,1–5,3) Mg (mg/dL) 1,8 ± 0,3 (1,1–4,6) LDL (mg/dL) 106,2 ± 34,2 (33–203) Regarding the etiology of CKD, hypertension was identified in 36 patients (24%), glomerulonephritis in 22 patients (14.7%), diabetes mellitus in 7 patients (4.7%), polycystic kidney disease in 8 patients (5.3%), and other causes in 28 patients (18.7%). The exact etiology was unknown in 49 patients (32.7%). Kidney transplant patients were receiving triple immunosuppressive therapy. A total of 138 patients were on prednisolone, 137 patients were on a mycophenolic acid derivative, 147 patients were on a calcineurin inhibitor, and 20 patients were on azathioprine. 2.Comparison of Patients Diagnosed with Sarcopenia and Those Without Sarcopenia When comparing patients with and without sarcopenia, no statistically significant differences were found in terms of age, total dialysis duration, transplantation duration, or type of transplantation (P > 0.05). When we examined the gender difference between the groups using the chi-square test, no significant findings were observed. In the comparison of laboratory values, only BUN and phosphorus parameters were found to be significantly different (P < 0.05) (Table 2 ). Table 2 Statistical Analysis of Demographic Characteristics, Laboratory Findings and Musculoskeletal System Parameters of Patients With and Without Sarcopenia. Parameter Sarcopenia (+) (N = 28) Sarcopenia (–) (N = 122) P Age (Year) 42,14 ± 13,5 45,16 ± 11 0,214 Sex n, (%) Male Female 21 (%75) 7 (%25) 76 (%62,3) 46 (%37,7) 0,09 Transplantation Type n, (%) Living donor Cadaveric donor 17 (%60,7) 11 (%39,3) 93 (%76,2) 29 (%23,8) 2,8 Total dialysis time (Year) 5,1 ± 5,6 3,4 ± 4,7 0,088 Kidney Transplant Duration (Month) 72,68 ± 44,33 87,8 ± 54,91 0,176 BUN (mg/dL) 26,64 ± 17,73 18,43 ± 8 0,02 Creatinine (mg/dL) 1,76 ± 1,29 1,27 ± 0,54 0,063 GFR (ml/dk) 62,93 ± 31,31 68,42 ± 21,77 0,385 Na (mEq/dL) 138,2 ± 3,1 139,3 ± 2,6 0,105 K (mEq/dL) 4,3 ± 0,5 4,3 ± 0,47 0,675 Ca (mg/dL) 9,4 ± 0,61 10 ± 7,1 0,624 P (mg/dL) 3,6 ± 0,77 3,2 ± 0,74 0,028 Albumin (mg/dL) 4,3 ± 0,39 4,4 ± 0,34 0,201 Mg (mg/dL) 1,8 ± 0,21 1,8 ± 0,31 0,742 LDL (mg/dL) 109 ± 44 105 ± 31 0,646 BMI (kg/m²) 20,94 ± 2,48 28,12 ± 4,52 < 0,0001 Fat percentage (%) 21,95 ± 7,5 30,72 ± 9,17 < 0,0001 Fat mass (kg) 12,82 ± 5,3 24,4 ± 9,66 < 0,0001 Total muscle mass (kg) 42,38 ± 6,6 50,47 ± 9,8 < 0,0001 Skeletal muscle mass (kg) 25,23 ± 3,96 29,93 ± 6,09 < 0,0001 SMI (kgm 2 ) 9,1 ± 0,78 10,82 ± 1,4 < 0,0001 Total mass (kg.m 2 ) 15,4 ± 1,3 18,25 ± 2,1 < 0,0001 When evaluating musculoskeletal system parameters, a significant difference was observed (P < 0.05). 3. Statistical Analysis of Patient Findings with SARC-F Scores Greater than 4 and Less than 4 : An analysis of SARC-F scores revealed that 12 patients had a SARC-F score greater than 4, while 138 patients had a SARC-F score less than 4. The mean age of patients with a SARC-F score greater than 4 was 55.25 ± 11.96 years. Among these patients, 2 were male (16.7%) and 10 were female (83.3%). Additionally, 8 patients (66.7%) underwent kidney transplantation from a living donor, whereas 4 patients (33.3%) received a kidney from a cadaveric donor. A statistical analysis of demographic and laboratory data between patients with SARC-F ≥ 4 and those with SARC-F < 4 showed a significant difference in albumin levels between the two groups (P < 0.05). When evaluating musculoskeletal parameters, as presented in Table 3 , a significant difference was observed in most parameters (P < 0.05). Moreover, unlike the comparison between patients diagnosed with sarcopenia and those without, the SARC-F groups demonstrated a statistically significant difference in handgrip strength and gait speed (P < 0.05). Table 3 Analysis of Demographic and Laboratory Findings of Patients with SARC-F Scores Greater than 4 and Less than 4. Parameter SARC-F greater than 4 (N = 12) SARC-F less than 4 (N = 138) P Age (Year) 55,25 ± 11,96 43,67 ± 11,09 0,01 Total dialysis time (Year) 4,19 ± 5,17 3,69 ± 4,91 0,752 Kidney Transplant Duration (Month) 87,75 ± 60,86 84,74 ± 52,82 0,871 BUN (mg/dL) 18,42 ± 8,82 20,09 ± 11,16 0,613 Creatinine (mg/dL) 1,09 ± 0,31 1,39 ± 0,78 0,192 GFR (ml/dk) 63,5 ± 17,8 67,73 ± 24,29 0,557 Na (mEq/dL) 138,5 ± 3,7 139,1 ± 2,7 0,420 K (mEq/dL) 4,44 ± 0,42 4,36 ± 0,48 0,575 Ca (mg/dL) 9,52 ± 0,67 9,99 ± 6,72 0,809 P (mg/dL) 3,58 ± 0,53 3,29 ± 0,77 0,206 Albumin (mg/dL) 4,08 ± 0,34 4,41 ± 0,34 0,002 Mg (mg/dL) 1,8 ± 0,2 1,83 ± 0,3 0,710 LDL (mg/dL) 96,33 ± 43 107,14 ± 33,47 0,296 Muscle percentage (%) 55,4 ± 9,53 68,26 ± 8,42 <0,0001 Total muscle mass (kg) 42,38 ± 6,84 49,53 ± 9,83 0,015 Skeletal muscle mass (kg) 25,25 ± 4,05 29,38 ± 6,07 0,022 Handgrip strength (kg) 23,04 ± 6,18 32,76 ± 9,87 0,002 Walking speed (m/s) 1,01 ± 0,26 1,33 ± 0,41 0,01 4.Correlation Analysis of SARC-F Scoring SARC-F was found to be negatively correlated with transplantation duration, creatinine, glomerular filtration rate (GFR), albumin, and magnesium, while showing a positive correlation with other parameters (Table 4 ). Table 4 Correlation of SARC-F with Patients’ Demographic, Laboratory, and Muscle Parameters Parameter P R Age (Year) < 0,0001 0,303 Total dialysis time (Year) 0,352 0,76 Kidney Transplant Duration (Month) 0,543 -0,05 BUN (Mg/dl) 0,527 0,527 Creatinine (mg/dL) 0,364 -0,075 GFR (ml/dk) 0,274 -0,09 Na (mEq/dL) 0,97 0,003 K (mEq/dL) 0,577 0,046 Ca (mg/dL) 0,501 0,055 P (mg/dL) 0,056 0,156 Albumin (mg/dL) < 0,0001 -0,348 Mg (mg/dL) 0,647 -0,038 TG (mg/dL) 0,07 0,07 LDL (mg/dL) 0,714 0,714 BMI(kg/m²) 0,016 0,197 Height < 0,0001 -0,294 Fat percentage (%) < 0,0001 0,434 Fat mass (kg) < 0,0001 0,293 Muscle percentage (%) < 0,0001 -0,438 Total muscle mass (kg) < 0,0001 -0,326 Skeletal muscle mass (kg) < 0,0001 -0,303 Handgrip strength (kg) < 0,0001 -0,385 Walking speed (m/s) < 0,0001 -0,315 SMI(kg.m 2 ) 0,009 -0,213 Total mass (kg.m 2 ) 0,002 -0,251 When examining sarcopenia-related parameters, SARC-F demonstrated a negative correlation, as expected, with muscle percentage, total muscle mass, skeletal muscle mass, skeletal muscle index, handgrip strength, and gait speed. Discussion In this study, we investigated the presence of sarcopenia in kidney transplant patients and its relationship with SARC-F scoring for the first time in the literature. Our findings indicate that while SARC-F is associated with sarcopenia-related parameters, it is not sufficient as a standalone tool to differentiate between patients with and without sarcopenia. Kidney transplant recipients face numerous complications in both the early and long-term post-transplant periods. These include vascular, urological, and immunological events in the early phase, as well as increased systemic infections due to prolonged immunosuppressive therapy, a heightened risk of certain cancers, increased cardiovascular risk, and osteoporosis [ 9 – 11 ]. Sarcopenia is also one of the significant complications encountered in kidney transplant patients [ 12 ]. The prevalence of sarcopenia in kidney transplant patients has been investigated in various studies. In a study conducted by Ozkayar et al. in 2014, which included 166 transplant patients, the prevalence of sarcopenia was reported as 20.5% (13). Similarly, in 2020, Martins et al. reported a sarcopenia prevalence of 19.3% in a study involving 83 renal transplant patients [ 12 ]. More recently, a 2023 meta-analysis by Zhang et al., which reviewed 23 studies, found the prevalence of sarcopenia among kidney transplant patients to be 26% (4). In our study, the prevalence of sarcopenia was found to be 22.9%, which is consistent with the existing literature. The development of sarcopenia in kidney transplant recipients is thought to be associated with nutritional deficiencies, malnutrition, vitamin D deficiency, metabolic acidosis, insulin resistance, low physical activity, hyperparathyroidism, uremia, and inflammation. Additionally, immunosuppressive drugs, including corticosteroids, commonly used after kidney transplantation, may contribute to the progression of sarcopenia [ 13 ]. In our study, a comparison between patients with and without sarcopenia revealed significant differences in body mass index (BMI), muscle percentage, total muscle mass, skeletal muscle mass, skeletal muscle index, fat percentage, fat mass, and total body mass parameters (p < 0.001). A review of similar studies in the literature consistently shows that musculoskeletal parameters are significantly lower in sarcopenic patients compared to non-sarcopenic patients [ 1 , 2 ]. SARC-F is a widely used five-item questionnaire designed to identify sarcopenia cases due to its simplicity and user-friendly nature. It was first developed in 2013 by Malmstrom and Morley, based on the idea that sarcopenia could be identified through simple functional questions. The authors aimed to provide a diagnostic tool that would eliminate the need for muscle mass measurements, which is often the most time-consuming and restrictive step in diagnosing sarcopenia. The total score ranges from 0 to 10, and a score of ≥ 4 is used as a threshold in primary care settings to suspect sarcopenia [ 7 ]. The European Working Group on Sarcopenia in Older People (EWGSOP) recommended the use of SARC-F as a screening tool in its 2018 guidelines, emphasizing that patients scoring ≥ 4 should undergo further diagnostic tests [ 1 ]. However, multiple studies have demonstrated that SARC-F, when used with the original cutoff score of ≥ 4, is not sufficient for diagnosing sarcopenia [ 14 ]. A meta-analysis conducted by Ida et al. in 2018, which included seven studies with a total of 12,800 participants, concluded that while SARC-F is not useful for diagnosing sarcopenia, it can be helpful in selecting patients for further testing [ 15 ]. Similarly, in 2020, Ishida et al. investigated the reliability of SARC-F in 1,689 hospitalized geriatric patients (aged ≥ 65 years). This study found a significant difference in appendicular skeletal muscle mass (ASM) and gait speed between patients with SARC-F scores above and below 4 [ 16 ]. Contrary to other studies, this research suggested that SARC-F may play a facilitating role in the early detection of sarcopenia in hospitalized patients, allowing for timely preventive and therapeutic interventions. In 2020, a meta-analysis conducted by Stefanie N. et al., which included 21,855 patients aged 60 years and older, concluded that while SARC-F has good reliability, it is not suitable for sarcopenia screening in adults [ 17 ]. SARC-F scoring has also been tested in dialysis patients. In a 2023 study by Wen Du et al., 125 dialysis-dependent and 105 non-dialysis chronic kidney disease (CKD) patients were screened for sarcopenia, and SARC-F scoring was used for sarcopenia prediction. The results showed that sarcopenia was identified in 6 non-dialysis CKD patients and 39 dialysis patients. However, among the total of 45 patients diagnosed with sarcopenia, only one dialysis-dependent patient had a SARC-F score above 4. This study demonstrated that while SARC-F scoring can be used for screening in CKD patients, it is not sufficient as a standalone diagnostic tool [ 18 ]. In summary, studies conducted in geriatric and chronic kidney disease (CKD) patients indicate that SARC-F is an effective screening tool but is not sufficient for diagnosing sarcopenia. Additionally, these studies demonstrate a correlation between higher SARC-F scores and a decline in musculoskeletal parameters in sarcopenic patients [ 18 ]. Our study, in alignment with previous literature, demonstrated a statistically significant association between SARC-F scores greater than 4 and declines in musculoskeletal parameters, including body mass index (BMI), total muscle mass, skeletal muscle mass, skeletal muscle index, fat percentage, gait speed, and handgrip strength. However, among the 12 patients with a SARC-F score above 4, only one was diagnosed with sarcopenia. This finding, consistent with the literature, suggests that while SARC-F scoring can be useful for screening purposes, it is insufficient as a standalone diagnostic tool for sarcopenia in kidney transplant patiebts. There are some limitations of our study. This study is a single-center, observational study. A control group was not included, as previous studies have already demonstrated a significantly higher prevalence of sarcopenia in kidney transplant patients compared to healthy controls. In conclusion , while our study contributes to the literature by determining the prevalence of sarcopenia in kidney transplant patients, it also demonstrates for the first time that the SARC-F score is associated with muscle mass and strength parameters in this patient group. However, it is not sufficient for diagnosing sarcopenia. Therefore, in addition to SARC-F scoring, assessing muscle mass and muscle function tests in kidney transplant patients is of critical importance. Abbreviations ESRD End-stage renal disease EWGSOP European Working Group on Sarcopenia in Older People CKD Chronic kidney disease BIA Bioelectrical Impedance Analysis GFR Glomerular filtration rate Declarations Authors’ contributions: Study design and execution, writing: OG, MA, NNOS; Statistical analyse of the study data: OA; Data collecting: MA, FBG, MS, NNOS, Review and editing: OG, OA, MS. Ethical approval Ethical approval was obtained from the KSU Ethics Committee (Decision No: 02) on 22/11/2022 .This research is the authors’ original work conducted in compliance with ethical standards. All sources used are properly cited. Informed consent to participate Written informed consent was obtained from all participants before enrollment. Competing interests The author declares that they have no competing interest. Data availability statement Authors elect to not share data Funding acknowledgement This study was not funded by any organisation References Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing. Volume 48. Oxford University Press; 2019. pp. 16–31. Nguyen TN, Nguyen AT, Khuong LQ, et al. Reliability and validity of SARC-F questionnaire to assess sarcopenia among vietnamese geriatric patients. Clin Interv Aging. 2020;15:879–86. Gungor Ozkan GF, Betül U, Sena, Zadeh Kamyar Kalantar. Sarcopenia in Patients with Chronic Kidney Disease. Turkish J Nephrol. 2022;31:3–6. Zhang JZ, Shi W, Zou M et al. (2023). Diagnosis, prevalence, and outcomes of sarcopenia in kidney transplantation recipients: A systematic review and meta-analysis. Vol. 14, Journal of Cachexia, Sarcopenia and Muscle. John Wiley and Sons Inc. pp. 17–29. Yanishi M, Kimura Y, Tsukaguchi H, et al. 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Ishida Y, Maeda K, Nonogaki T, et al. SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults. J Nutr Health Aging. 2020;24(10):1053–60. Voelker SN, Michalopoulos N, Maier AB, Reijnierse EM. Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc. 2021;22(9):1864–e187616. Du W, Gao C, Wang X et al. (2023). Validity of the SARC-F questionnaire in assessing sarcopenia in patients with chronic kidney disease: a cross-sectional study. Front Med (Lausanne) Jul 18;10. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7321096","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":532707464,"identity":"f1f79c85-156d-4589-9a23-f6b761fe2547","order_by":0,"name":"Mahmut Armagan","email":"","orcid":"","institution":"Kahramanmaraş Sütçü İmam University","correspondingAuthor":false,"prefix":"","firstName":"Mahmut","middleName":"","lastName":"Armagan","suffix":""},{"id":532707465,"identity":"3261d145-d4b7-4b0d-b169-c5e59e7b85ae","order_by":1,"name":"Nazife Nur Ozer 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Sahin","email":"","orcid":"","institution":"Kahramanmaraş Sütçü İmam University","correspondingAuthor":false,"prefix":"","firstName":"Murat","middleName":"","lastName":"Sahin","suffix":""},{"id":532707468,"identity":"046ebb81-2872-4b5d-b2b1-2a77b8df1340","order_by":4,"name":"Orcun Altunoren","email":"","orcid":"","institution":"Kahramanmaraş Sütçü İmam University","correspondingAuthor":false,"prefix":"","firstName":"Orcun","middleName":"","lastName":"Altunoren","suffix":""},{"id":532707469,"identity":"67d31299-684a-4b67-adf5-9a31e93dfa80","order_by":5,"name":"Ozkan Gungor","email":"","orcid":"","institution":"Kahramanmaraş Sütçü İmam University","correspondingAuthor":false,"prefix":"","firstName":"Ozkan","middleName":"","lastName":"Gungor","suffix":""}],"badges":[],"createdAt":"2025-08-07 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19:33:22","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":124651,"visible":true,"origin":"","legend":"","description":"","filename":"09fc93b9f2804b82b5685272e4596cc41structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7321096/v1/6bc8dd139b2a55607a53857a.xml"},{"id":94139403,"identity":"bbb0caf9-2935-41bf-9b13-7746c12b00ed","added_by":"auto","created_at":"2025-10-22 19:33:22","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":134169,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7321096/v1/67718673eae9000c2168f099.html"},{"id":94139396,"identity":"ec925587-6d09-4052-bc97-bc138203d8f9","added_by":"auto","created_at":"2025-10-22 19:33:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":60126,"visible":true,"origin":"","legend":"\u003cp\u003eSARC-F Score.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7321096/v1/8dcd5f37feac739defc72874.png"},{"id":97893574,"identity":"0a7e62c1-2b6d-4a0f-bea9-4a0063623adc","added_by":"auto","created_at":"2025-12-10 15:30:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":995984,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7321096/v1/f319769c-4422-488d-a65e-029b5d7de8e1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Should We Use the SARC-F Score in Sarcopenia Screening in Kidney Transplant Patients?","fulltext":[{"header":"Introduction","content":"\u003cp\u003eKidney transplantation improves survival and quality of life in patients with end-stage renal disease (ESRD) and is superior to dialysis therapy. Therefore, it has become the first-line treatment choice for ESRD management.\u003c/p\u003e\u003cp\u003eThe term sarcopenia was first introduced in 1989 to describe age-related loss of muscle mass. Despite decades since its initial definition, the concept and its clinical implications remain controversial [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. To establish a standardized definition, the European Working Group on Sarcopenia in Older People (EWGSOP) was formed by the European Geriatric Society. This group has reported that sarcopenia may lead to reduced mobility, increased risk of falls and fractures, lower quality of life, and even mortality [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe clinical definition of sarcopenia is based on parameters such as body muscle mass, handgrip strength, and walking speed. However, assessing sarcopenia in clinical practice requires time and space. Therefore, an ideal screening tool should be simple, practical, and cost-effective. In this context, Malmstrom (2013) developed the SARC-F questionnaire, a rapid and easily applicable screening tool for clinical use [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSarcopenia results in progressive loss of muscle strength and mass, and it may develop due to primary or secondary causes. Among the secondary causes, chronic kidney disease (CKD) and long-term glucocorticoid use are recognized contributors [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In CKD-related sarcopenia, the imbalance between anabolic and catabolic processes controlling muscle homeostasis plays a critical role. Metabolic acidosis and inflammation associated with CKD contribute to muscle strength loss from the early stages of conservative treatment [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Sarcopenia in CKD is strongly linked to increased morbidity, higher mortality, physical disability, and a greater risk of cardiovascular events [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn recent years, several studies have investigated sarcopenia in kidney transplant recipients; however, literature data remain insufficient. Studies evaluating sarcopenia prevalence in this population have reported wide variations due to differences in diagnostic criteria [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Research indicates that sarcopenia manifests at a younger age in kidney transplant recipients compared to the general population [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhile some studies in CKD and other populations have demonstrated a strong association between SARC-F scores and sarcopenia [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], others have found it to be less predictive [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eTo date, no studies have evaluated the use of SARC-F scoring in kidney transplant patients.\u003c/p\u003e\u003cp\u003eIn this study, we aimed to investigate, for the first time in the literature, the relationship between SARC-F scores and sarcopenia parameters in kidney transplant recipients.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThis study is a cross-sectional case-control study conducted by the Department of Nephrology at Kahramanmaraş S\u0026uuml;tc\u0026uuml; Imam University Faculty of Medicine. Ethical approval was obtained from the KSU Ethics Committee (Decision No: 02) on 22/11/2022, and written informed consent was obtained from all participants before enrollment.\u003c/p\u003e\n\u003cp\u003eThe study included 150 kidney transplant recipients (97 males, 53 females) who were over 18 years of age and had undergone kidney transplantation at least three months prior. Patients were excluded if they were under 18 years old, had undergone transplantation less than three months prior, or had mobility impairments.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch2\u003eData Collection\u003c/h2\u003e\n\u003cp\u003eDemographic and clinical data, including age, sex, comorbid conditions (such as hypertension, diabetes mellitus, or coronary artery disease), etiology of CKD, duration of hemodialysis before transplantation, post-transplantation period, type of kidney transplant (living donor or cadaveric), and immunosuppressive medications, were collected from patient interviews and electronic medical records.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eLaboratory Analysis\u003c/h3\u003e\n\u003cp\u003eOn the day of their follow-up visit, patients' laboratory parameters were retrieved from the hospital's electronic medical record system. These included: serum urea and creatinine (Cr), Sodium (Na), potassium (K), calcium (Ca), phosphorus (P) levels, low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels, serum albumin levels and spot urine protein and spot urine creatinine levels.\u003c/p\u003e\n\u003ch3\u003eAnthropometric Measurements\u003c/h3\u003e\n\u003cp\u003eVolunteers were taken to the measurement room on the day of their clinic visit. Handgrip strength was assessed using a Kyto digital hand dynamometer to evaluate muscle strength. The volunteers were first instructed on how to use the dynamometer. Measurements were then taken from the dominant upper extremity, and the highest value from three attempts was recorded.\u003c/p\u003e\n\u003cp\u003eMuscle mass measurements were conducted using Bioelectrical Impedance Analysis (BIA), with the Tanita DC 360 ST body analysis device. BIA provided calculations of fat percentage, muscle percentage, mineral percentage, protein percentage, fluid ratio, fat-free mass, fat mass, muscle mass, bone mass, and skeletal muscle mass, which were recorded.\u003c/p\u003e\n\u003cp\u003eFor the assessment of walking speed, volunteers were asked to walk at their usual daily pace along a straight line marked on the floor of the measurement room. The obtained data were recorded in meters per second (m/s).\u003c/p\u003e\n\u003cp\u003eThe presence of sarcopenia was determined according to the 2018 EWGSOP criteria.\u003c/p\u003e\n\u003ch3\u003eSARC-F Scoring\u003c/h3\u003e\n\u003cp\u003eSARC-F evaluates muscle strength, walking ability, ability to rise from a chair, stair climbing, and the frequency of spontaneous falls. The five-question test assigns a score ranging from \u003cstrong\u003e0 to 2\u003c/strong\u003e for each question. A total score of 4 or higher is considered indicative of high sarcopenia risk, warranting further evaluation [\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\n\u003cp\u003eIn our study, SARC-F scoring (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) was calculated and recorded prior to anthropometric analysis.\u0026nbsp;\u003c/p\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\n\u003cp\u003eStatistical analysis was performed using IBM SPSS Statistics for Windows, Version 27.0 (IBM Corp., Released 2020), and statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Descriptive data were presented as count (n), percentage (%), mean (M), and standard deviation (SD).\u003c/p\u003e\n\u003cp\u003eKolmogorov-Smirnov and Shapiro-Wilk tests were used to assess normality of data distribution. For normally distributed data, comparisons between two groups were conducted using the Independent Samples T-test. For non-normally distributed data, the Mann-Whitney U test, a nonparametric alternative, was applied.\u003c/p\u003e\n\u003cp\u003eFor categorical data comparisons, the Chi-square test was used. Correlation analysis between SARC-F scores and demographic, laboratory, and musculoskeletal parameters was conducted using the Pearson and Spearman correlation tests.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cb\u003e1.General Population Demographics, Laboratory, and Musculoskeletal Findings\u003c/b\u003e:\u003c/p\u003e\u003cp\u003eThe study included 150 kidney transplant recipients, comprising 97 male patients (64.7%) and 53 female patients (35.3%). The mean age of the patients was 44.6\u0026thinsp;\u0026plusmn;\u0026thinsp;11.5 years. Of the total participants, 110 patients (73.3%) underwent kidney transplantation from a living donor, while 40 patients (26.7%) received a cadaveric kidney transplant. The mean post-transplant period was 84.98\u0026thinsp;\u0026plusmn;\u0026thinsp;53.2 months (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eGeneral laboratory data of patients.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e44,6\u0026thinsp;\u0026plusmn;\u0026thinsp;11,5(19\u0026ndash;72)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal dialysis time (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3,7\u0026thinsp;\u0026plusmn;\u0026thinsp;4,9 (0\u0026ndash;16)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKidney Transplant Duration (Month)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e84,98\u0026thinsp;\u0026plusmn;\u0026thinsp;53,2 (4-252)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e19,9\u0026thinsp;\u0026plusmn;\u0026thinsp;10,9 (8\u0026ndash;79)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinine (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,7 (0.61-5,72)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGFR (ml/dk)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e67,3\u0026thinsp;\u0026plusmn;\u0026thinsp;23,8 (11\u0026ndash;127)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNa (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e139,1\u0026thinsp;\u0026plusmn;\u0026thinsp;2,7 (128\u0026ndash;146)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,48 (2,9\u0026thinsp;\u0026minus;\u0026thinsp;5,6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCa (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,9\u0026thinsp;\u0026plusmn;\u0026thinsp;6,4 (6,5\u0026ndash;11,4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eP (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,75 (1,46\u0026thinsp;\u0026minus;\u0026thinsp;6,59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlbumin (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,35 (3,1\u0026ndash;5,3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMg (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,3 (1,1\u0026ndash;4,6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e106,2\u0026thinsp;\u0026plusmn;\u0026thinsp;34,2 (33\u0026ndash;203)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eRegarding the etiology of CKD, hypertension was identified in 36 patients (24%), glomerulonephritis in 22 patients (14.7%), diabetes mellitus in 7 patients (4.7%), polycystic kidney disease in 8 patients (5.3%), and other causes in 28 patients (18.7%). The exact etiology was unknown in 49 patients (32.7%).\u003c/p\u003e\u003cp\u003eKidney transplant patients were receiving triple immunosuppressive therapy. A total of 138 patients were on prednisolone, 137 patients were on a mycophenolic acid derivative, 147 patients were on a calcineurin inhibitor, and 20 patients were on azathioprine.\u003c/p\u003e\u003cp\u003e\u003cb\u003e2.Comparison of Patients Diagnosed with Sarcopenia and Those Without Sarcopenia\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWhen comparing patients with and without sarcopenia, no statistically significant differences were found in terms of age, total dialysis duration, transplantation duration, or type of transplantation (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). When we examined the gender difference between the groups using the chi-square test, no significant findings were observed.\u003c/p\u003e\u003cp\u003eIn the comparison of laboratory values, only BUN and phosphorus parameters were found to be significantly different (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStatistical Analysis of Demographic Characteristics, Laboratory Findings and Musculoskeletal System Parameters of Patients With and Without Sarcopenia.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSarcopenia (+)\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSarcopenia (\u0026ndash;)\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;122)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e42,14\u0026thinsp;\u0026plusmn;\u0026thinsp;13,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e45,16\u0026thinsp;\u0026plusmn;\u0026thinsp;11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,214\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex n, (%)\u003c/p\u003e\u003cp\u003eMale\u003c/p\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21 (%75)\u003c/p\u003e\u003cp\u003e7 (%25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76 (%62,3)\u003c/p\u003e\u003cp\u003e46 (%37,7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTransplantation Type n, (%)\u003c/p\u003e\u003cp\u003eLiving donor\u003c/p\u003e\u003cp\u003eCadaveric donor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17 (%60,7)\u003c/p\u003e\u003cp\u003e11 (%39,3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e93 (%76,2)\u003c/p\u003e\u003cp\u003e29 (%23,8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2,8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal dialysis time (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5,1\u0026thinsp;\u0026plusmn;\u0026thinsp;5,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3,4\u0026thinsp;\u0026plusmn;\u0026thinsp;4,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,088\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKidney Transplant Duration (Month)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e72,68\u0026thinsp;\u0026plusmn;\u0026thinsp;44,33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e87,8\u0026thinsp;\u0026plusmn;\u0026thinsp;54,91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,176\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e26,64\u0026thinsp;\u0026plusmn;\u0026thinsp;17,73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e18,43\u0026thinsp;\u0026plusmn;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,02\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinine (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1,76\u0026thinsp;\u0026plusmn;\u0026thinsp;1,29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1,27\u0026thinsp;\u0026plusmn;\u0026thinsp;0,54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,063\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGFR (ml/dk)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e62,93\u0026thinsp;\u0026plusmn;\u0026thinsp;31,31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e68,42\u0026thinsp;\u0026plusmn;\u0026thinsp;21,77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,385\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNa (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e138,2\u0026thinsp;\u0026plusmn;\u0026thinsp;3,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e139,3\u0026thinsp;\u0026plusmn;\u0026thinsp;2,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,105\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,675\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCa (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,4\u0026thinsp;\u0026plusmn;\u0026thinsp;0,61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e10\u0026thinsp;\u0026plusmn;\u0026thinsp;7,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,624\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eP (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3,6\u0026thinsp;\u0026plusmn;\u0026thinsp;0,77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3,2\u0026thinsp;\u0026plusmn;\u0026thinsp;0,74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,028\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlbumin (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4,3\u0026thinsp;\u0026plusmn;\u0026thinsp;0,39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4,4\u0026thinsp;\u0026plusmn;\u0026thinsp;0,34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,201\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMg (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,742\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e109\u0026thinsp;\u0026plusmn;\u0026thinsp;44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e105\u0026thinsp;\u0026plusmn;\u0026thinsp;31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,646\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e20,94\u0026thinsp;\u0026plusmn;\u0026thinsp;2,48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e28,12\u0026thinsp;\u0026plusmn;\u0026thinsp;4,52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat percentage (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e21,95\u0026thinsp;\u0026plusmn;\u0026thinsp;7,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e30,72\u0026thinsp;\u0026plusmn;\u0026thinsp;9,17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e12,82\u0026thinsp;\u0026plusmn;\u0026thinsp;5,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e24,4\u0026thinsp;\u0026plusmn;\u0026thinsp;9,66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e42,38\u0026thinsp;\u0026plusmn;\u0026thinsp;6,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e50,47\u0026thinsp;\u0026plusmn;\u0026thinsp;9,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkeletal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e25,23\u0026thinsp;\u0026plusmn;\u0026thinsp;3,96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e29,93\u0026thinsp;\u0026plusmn;\u0026thinsp;6,09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSMI (kgm\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,1\u0026thinsp;\u0026plusmn;\u0026thinsp;0,78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e10,82\u0026thinsp;\u0026plusmn;\u0026thinsp;1,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal mass (kg.m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e15,4\u0026thinsp;\u0026plusmn;\u0026thinsp;1,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e18,25\u0026thinsp;\u0026plusmn;\u0026thinsp;2,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWhen evaluating musculoskeletal system parameters, a significant difference was observed (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003e\u003cb\u003e3. Statistical Analysis of Patient Findings with SARC-F Scores Greater than 4 and Less than 4\u003c/b\u003e:\u003c/p\u003e\u003cp\u003eAn analysis of SARC-F scores revealed that 12 patients had a SARC-F score greater than 4, while 138 patients had a SARC-F score less than 4. The mean age of patients with a SARC-F score greater than 4 was 55.25\u0026thinsp;\u0026plusmn;\u0026thinsp;11.96 years. Among these patients, 2 were male (16.7%) and 10 were female (83.3%). Additionally, 8 patients (66.7%) underwent kidney transplantation from a living donor, whereas 4 patients (33.3%) received a kidney from a cadaveric donor.\u003c/p\u003e\u003cp\u003eA statistical analysis of demographic and laboratory data between patients with SARC-F\u0026thinsp;\u0026ge;\u0026thinsp;4 and those with SARC-F\u0026thinsp;\u0026lt;\u0026thinsp;4 showed a significant difference in albumin levels between the two groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). When evaluating musculoskeletal parameters, as presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, a significant difference was observed in most parameters (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Moreover, unlike the comparison between patients diagnosed with sarcopenia and those without, the SARC-F groups demonstrated a statistically significant difference in handgrip strength and gait speed (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAnalysis of Demographic and Laboratory Findings of Patients with SARC-F Scores Greater than 4 and Less than 4.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSARC-F greater than 4\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSARC-F less than 4\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;138)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e55,25\u0026thinsp;\u0026plusmn;\u0026thinsp;11,96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e43,67\u0026thinsp;\u0026plusmn;\u0026thinsp;11,09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal dialysis time (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4,19\u0026thinsp;\u0026plusmn;\u0026thinsp;5,17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3,69\u0026thinsp;\u0026plusmn;\u0026thinsp;4,91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,752\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKidney Transplant Duration (Month)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e87,75\u0026thinsp;\u0026plusmn;\u0026thinsp;60,86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e84,74\u0026thinsp;\u0026plusmn;\u0026thinsp;52,82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,871\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e18,42\u0026thinsp;\u0026plusmn;\u0026thinsp;8,82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e20,09\u0026thinsp;\u0026plusmn;\u0026thinsp;11,16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,613\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinine (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1,09\u0026thinsp;\u0026plusmn;\u0026thinsp;0,31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1,39\u0026thinsp;\u0026plusmn;\u0026thinsp;0,78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,192\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGFR (ml/dk)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e63,5\u0026thinsp;\u0026plusmn;\u0026thinsp;17,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e67,73\u0026thinsp;\u0026plusmn;\u0026thinsp;24,29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,557\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNa (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e138,5\u0026thinsp;\u0026plusmn;\u0026thinsp;3,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e139,1\u0026thinsp;\u0026plusmn;\u0026thinsp;2,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,420\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4,44\u0026thinsp;\u0026plusmn;\u0026thinsp;0,42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4,36\u0026thinsp;\u0026plusmn;\u0026thinsp;0,48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,575\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCa (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9,52\u0026thinsp;\u0026plusmn;\u0026thinsp;0,67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e9,99\u0026thinsp;\u0026plusmn;\u0026thinsp;6,72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,809\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eP (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3,58\u0026thinsp;\u0026plusmn;\u0026thinsp;0,53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3,29\u0026thinsp;\u0026plusmn;\u0026thinsp;0,77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,206\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlbumin (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4,08\u0026thinsp;\u0026plusmn;\u0026thinsp;0,34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4,41\u0026thinsp;\u0026plusmn;\u0026thinsp;0,34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMg (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1,8\u0026thinsp;\u0026plusmn;\u0026thinsp;0,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1,83\u0026thinsp;\u0026plusmn;\u0026thinsp;0,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,710\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e96,33\u0026thinsp;\u0026plusmn;\u0026thinsp;43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e107,14\u0026thinsp;\u0026plusmn;\u0026thinsp;33,47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0,296\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMuscle percentage (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e55,4\u0026thinsp;\u0026plusmn;\u0026thinsp;9,53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e68,26\u0026thinsp;\u0026plusmn;\u0026thinsp;8,42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e42,38\u0026thinsp;\u0026plusmn;\u0026thinsp;6,84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e49,53\u0026thinsp;\u0026plusmn;\u0026thinsp;9,83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,015\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkeletal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e25,25\u0026thinsp;\u0026plusmn;\u0026thinsp;4,05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e29,38\u0026thinsp;\u0026plusmn;\u0026thinsp;6,07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,022\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHandgrip strength (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e23,04\u0026thinsp;\u0026plusmn;\u0026thinsp;6,18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e32,76\u0026thinsp;\u0026plusmn;\u0026thinsp;9,87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWalking speed (m/s)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1,01\u0026thinsp;\u0026plusmn;\u0026thinsp;0,26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e1,33\u0026thinsp;\u0026plusmn;\u0026thinsp;0,41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0,01\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e4.Correlation Analysis of SARC-F Scoring\u003c/b\u003e\u003c/p\u003e\u003cp\u003eSARC-F was found to be negatively correlated with transplantation duration, creatinine, glomerular filtration rate (GFR), albumin, and magnesium, while showing a positive correlation with other parameters (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation of SARC-F with Patients\u0026rsquo; Demographic, Laboratory, and Muscle Parameters\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eR\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,303\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal dialysis time (Year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,352\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKidney Transplant Duration (Month)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,543\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0,05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN (Mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,527\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,527\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinine (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,364\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0,075\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGFR (ml/dk)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,274\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0,09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNa (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK (mEq/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,577\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,046\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCa (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,501\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,055\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eP (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,056\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,156\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlbumin (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0,348\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMg (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,647\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0,038\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTG (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,07\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL (mg/dL)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,714\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,714\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI(kg/m\u0026sup2;)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0,016\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,197\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,294\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat percentage (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,434\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,293\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMuscle percentage (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,438\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,326\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkeletal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,303\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHandgrip strength (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,385\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWalking speed (m/s)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,0001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,315\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSMI(kg.m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0,009\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,213\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal mass (kg.m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0,002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e-0,251\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWhen examining sarcopenia-related parameters, SARC-F demonstrated a negative correlation, as expected, with muscle percentage, total muscle mass, skeletal muscle mass, skeletal muscle index, handgrip strength, and gait speed.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we investigated the presence of sarcopenia in kidney transplant patients and its relationship with SARC-F scoring for the first time in the literature. Our findings indicate that while SARC-F is associated with sarcopenia-related parameters, it is not sufficient as a standalone tool to differentiate between patients with and without sarcopenia.\u003c/p\u003e\u003cp\u003eKidney transplant recipients face numerous complications in both the early and long-term post-transplant periods. These include vascular, urological, and immunological events in the early phase, as well as increased systemic infections due to prolonged immunosuppressive therapy, a heightened risk of certain cancers, increased cardiovascular risk, and osteoporosis [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Sarcopenia is also one of the significant complications encountered in kidney transplant patients [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe prevalence of sarcopenia in kidney transplant patients has been investigated in various studies. In a study conducted by Ozkayar et al. in 2014, which included 166 transplant patients, the prevalence of sarcopenia was reported as 20.5% (13). Similarly, in 2020, Martins et al. reported a sarcopenia prevalence of 19.3% in a study involving 83 renal transplant patients [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. More recently, a 2023 meta-analysis by Zhang et al., which reviewed 23 studies, found the prevalence of sarcopenia among kidney transplant patients to be 26% (4). In our study, the prevalence of sarcopenia was found to be 22.9%, which is consistent with the existing literature.\u003c/p\u003e\u003cp\u003eThe development of sarcopenia in kidney transplant recipients is thought to be associated with nutritional deficiencies, malnutrition, vitamin D deficiency, metabolic acidosis, insulin resistance, low physical activity, hyperparathyroidism, uremia, and inflammation. Additionally, immunosuppressive drugs, including corticosteroids, commonly used after kidney transplantation, may contribute to the progression of sarcopenia [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn our study, a comparison between patients with and without sarcopenia revealed significant differences in body mass index (BMI), muscle percentage, total muscle mass, skeletal muscle mass, skeletal muscle index, fat percentage, fat mass, and total body mass parameters (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A review of similar studies in the literature consistently shows that musculoskeletal parameters are significantly lower in sarcopenic patients compared to non-sarcopenic patients [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSARC-F is a widely used five-item questionnaire designed to identify sarcopenia cases due to its simplicity and user-friendly nature. It was first developed in 2013 by Malmstrom and Morley, based on the idea that sarcopenia could be identified through simple functional questions. The authors aimed to provide a diagnostic tool that would eliminate the need for muscle mass measurements, which is often the most time-consuming and restrictive step in diagnosing sarcopenia. The total score ranges from 0 to 10, and a score of \u0026ge;\u0026thinsp;4 is used as a threshold in primary care settings to suspect sarcopenia [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The European Working Group on Sarcopenia in Older People (EWGSOP) recommended the use of SARC-F as a screening tool in its 2018 guidelines, emphasizing that patients scoring\u0026thinsp;\u0026ge;\u0026thinsp;4 should undergo further diagnostic tests [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eHowever, multiple studies have demonstrated that SARC-F, when used with the original cutoff score of \u0026ge;\u0026thinsp;4, is not sufficient for diagnosing sarcopenia [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. A meta-analysis conducted by Ida et al. in 2018, which included seven studies with a total of 12,800 participants, concluded that while SARC-F is not useful for diagnosing sarcopenia, it can be helpful in selecting patients for further testing [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Similarly, in 2020, Ishida et al. investigated the reliability of SARC-F in 1,689 hospitalized geriatric patients (aged\u0026thinsp;\u0026ge;\u0026thinsp;65 years). This study found a significant difference in appendicular skeletal muscle mass (ASM) and gait speed between patients with SARC-F scores above and below 4 [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Contrary to other studies, this research suggested that SARC-F may play a facilitating role in the early detection of sarcopenia in hospitalized patients, allowing for timely preventive and therapeutic interventions.\u003c/p\u003e\u003cp\u003eIn 2020, a meta-analysis conducted by Stefanie N. et al., which included 21,855 patients aged 60 years and older, concluded that while SARC-F has good reliability, it is not suitable for sarcopenia screening in adults [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSARC-F scoring has also been tested in dialysis patients. In a 2023 study by Wen Du et al., 125 dialysis-dependent and 105 non-dialysis chronic kidney disease (CKD) patients were screened for sarcopenia, and SARC-F scoring was used for sarcopenia prediction. The results showed that sarcopenia was identified in 6 non-dialysis CKD patients and 39 dialysis patients. However, among the total of 45 patients diagnosed with sarcopenia, only one dialysis-dependent patient had a SARC-F score above 4. This study demonstrated that while SARC-F scoring can be used for screening in CKD patients, it is not sufficient as a standalone diagnostic tool [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn summary, studies conducted in geriatric and chronic kidney disease (CKD) patients indicate that SARC-F is an effective screening tool but is not sufficient for diagnosing sarcopenia. Additionally, these studies demonstrate a correlation between higher SARC-F scores and a decline in musculoskeletal parameters in sarcopenic patients [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOur study, in alignment with previous literature, demonstrated a statistically significant association between SARC-F scores greater than 4 and declines in musculoskeletal parameters, including body mass index (BMI), total muscle mass, skeletal muscle mass, skeletal muscle index, fat percentage, gait speed, and handgrip strength. However, among the 12 patients with a SARC-F score above 4, only one was diagnosed with sarcopenia. This finding, consistent with the literature, suggests that while SARC-F scoring can be useful for screening purposes, it is insufficient as a standalone diagnostic tool for sarcopenia in kidney transplant patiebts.\u003c/p\u003e\u003cp\u003eThere are some limitations of our study. This study is a single-center, observational study. A control group was not included, as previous studies have already demonstrated a significantly higher prevalence of sarcopenia in kidney transplant patients compared to healthy controls.\u003c/p\u003e\u003cp\u003e\u003cb\u003eIn conclusion\u003c/b\u003e, while our study contributes to the literature by determining the prevalence of sarcopenia in kidney transplant patients, it also demonstrates for the first time that the SARC-F score is associated with muscle mass and strength parameters in this patient group. However, it is not sufficient for diagnosing sarcopenia. Therefore, in addition to SARC-F scoring, assessing muscle mass and muscle function tests in kidney transplant patients is of critical importance.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eESRD \u0026nbsp; End-stage renal disease\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEWGSOP \u0026nbsp; \u0026nbsp;European Working Group on Sarcopenia in Older People\u003c/p\u003e\n\u003cp\u003eCKD \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Chronic kidney disease\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBIA \u0026nbsp; Bioelectrical Impedance Analysis\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGFR \u0026nbsp; Glomerular filtration rate\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u0026nbsp;\u003c/strong\u003eStudy design and execution, writing: OG, MA, NNOS; Statistical analyse of the study data: OA; Data collecting: MA, FBG, MS, NNOS, Review and editing: OG, OA, MS.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the \u003cstrong\u003eKSU Ethics Committee (Decision No: 02) on 22/11/2022\u003c/strong\u003e.This research is the authors\u0026rsquo; original work conducted in compliance with ethical standards. All sources used are properly cited.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWritten informed consent\u003c/strong\u003e was obtained from all participants before enrollment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declares that they have no competing interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors elect to not share data\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding acknowledgement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was not funded by any organisation\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing. Volume 48. Oxford University Press; 2019. pp. 16\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNguyen TN, Nguyen AT, Khuong LQ, et al. Reliability and validity of SARC-F questionnaire to assess sarcopenia among vietnamese geriatric patients. Clin Interv Aging. 2020;15:879\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGungor Ozkan GF, Bet\u0026uuml;l U, Sena, Zadeh Kamyar Kalantar. Sarcopenia in Patients with Chronic Kidney Disease. Turkish J Nephrol. 2022;31:3\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang JZ, Shi W, Zou M et al. (2023). Diagnosis, prevalence, and outcomes of sarcopenia in kidney transplantation recipients: A systematic review and meta-analysis. Vol. 14, Journal of Cachexia, Sarcopenia and Muscle. John Wiley and Sons Inc. pp. 17\u0026ndash;29.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYanishi M, Kimura Y, Tsukaguchi H, et al. Factors Associated With the Development of Sarcopenia in Kidney Transplant Recipients. Transpl Proc. 2017;49(2):288\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMenna Barreto APM, Barreto Silva MI, Pontes KSDS, et al. Sarcopenia and its components in adult renal transplant recipients: prevalence and association with body adiposity. Br J Nutr. 2019;122(12):1386\u0026ndash;97.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMalmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: A symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVoelker SN, Michalopoulos N, Maier AB, Reijnierse EM. Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis. Journal of the American Medical Directors Association. Volume 22. Elsevier Inc.; 2021. pp. 1864\u0026ndash;e187616.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRangaswami J, Mathew RO, Parasuraman R, et al. Cardiovascular disease in the kidney transplant recipient: epidemiology, diagnosis and management strategies. Nephrol Dialysis Transplantation. 2019;34(5):760\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAgrawal A, Ison MG, Danziger-Isakov L. Long-Term Infectious Complications of Kidney Transplantation. Clin J Am Soc Nephrol. 2022;17(2):286\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDounousi E, Leivaditis K, Eleftheriadis T, Liakopoulos V. Osteoporosis after renal transplantation. Int Urol Nephrol. 2015;47(3):503\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMartins CA, da Cunha Fran\u0026ccedil;a AKT, Dias RSC, et al. Prevalence of sarcopenia in kidney transplants and their association with determinant factors of muscle homeostasis. Rev Assoc Med Bras. 2020;66(9):1235\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOzkayar N, Altun B, Halil M, et al. Evaluation of sarcopenia in renal transplant recipients. Nephrourol Mon. 2014;6(4):e20055.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWoo J, Leung J, Morley JE. Validating the SARC-F: A Suitable Community Screening Tool for Sarcopenia? J Am Med Dir Assoc. 2014;15(9):630\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIda S, Kaneko R, Murata K. SARC-F for Screening of Sarcopenia Among Older Adults: A Meta-analysis of Screening Test Accuracy. J Am Med Dir Assoc. 2018;19(8):685\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIshida Y, Maeda K, Nonogaki T, et al. SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults. J Nutr Health Aging. 2020;24(10):1053\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVoelker SN, Michalopoulos N, Maier AB, Reijnierse EM. Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc. 2021;22(9):1864\u0026ndash;e187616.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDu W, Gao C, Wang X et al. (2023). Validity of the SARC-F questionnaire in assessing sarcopenia in patients with chronic kidney disease: a cross-sectional study. Front Med (Lausanne) Jul 18;10.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Kidney transplantation, SARC-F, sarcopenia, screening","lastPublishedDoi":"10.21203/rs.3.rs-7321096/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7321096/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackgrounds\u003c/b\u003e The risk of sarcopenia is increased in kidney transplant (KT) patients. The SARC-F score is a reliable tool used for sarcopenia screening; however, it has not been tested in KT patients.\u003c/p\u003e\u003cp\u003e\u003cb\u003eObjective\u003c/b\u003e The aim of our study is to assess the prevalence of sarcopenia in KT recipients and to investigate the relationship between the SARC-F score and sarcopenia parameters.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e The study included 150 KT patients. Body muscle mass was measured using the Tanita DC 360 ST device. Before these measurements, patients were scored using the five-question SARC-F assessment, and their scores were recorded.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e 28 patients were diagnosed with sarcopenia, yielding a sarcopenia prevalence of 22.9%. The mean age of the patients was 42\u0026thinsp;\u0026plusmn;\u0026thinsp;13.5 years.\u003c/p\u003e\u003cp\u003eCorrelation analysis of SARC-F scoring results revealed a negative correlation between SARC-F and total muscle mass, muscle percentage, skeletal muscle mass, skeletal muscle index, grip strength, and walking speed parameters, as expected.\u003c/p\u003e\u003cp\u003eAnalysis of SARC-F scores showed that only 12 of the 150 patients had a SARC-F score greater than 4. Patients with SARC-F\u0026thinsp;\u0026ge;\u0026thinsp;4 had significantly lower musculoskeletal parameters (BMI, total muscle mass, skeletal muscle mass, and skeletal muscle index) compared to those with SARC-F\u0026thinsp;\u0026lt;\u0026thinsp;4 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). However, only one of these patients met the criteria for sarcopenia.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e The findings of this study indicate that the SARC-F score is associated with muscle mass and strength parameters in KT patients and may be used as a screening tool. However, it is not sufficient as a standalone diagnostic tool for sarcopenia.\u003c/p\u003e","manuscriptTitle":"Should We Use the SARC-F Score in Sarcopenia Screening in Kidney Transplant Patients?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-22 19:33:17","doi":"10.21203/rs.3.rs-7321096/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"663a319e-6c25-44e5-9af0-35de547be60d","owner":[],"postedDate":"October 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T10:25:00+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-22 19:33:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7321096","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7321096","identity":"rs-7321096","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}