{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:00:00Z","timestamp":1790658000485,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease is a major global health burden linked to malnutrition, sarcopenia and related nutritional syndromes including protein\u2010energy wasting (PEW)\/cachexia and sarcopenic obesity (SO). Data from end\u2010stage kidney disease (ESKD) populations in Saudi Arabia and the wider Middle East are scarce. This study assessed the prevalence and factors associated with malnutrition and sarcopenia risk in a large haemodialysis (HD) cohort and the co\u2010occurrence of PEW\/cachexia risk and SO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Multicentre, cross\u2010sectional study in 40 dialysis clinics across Saudi Arabia (June\u2013August 2024). Adults on maintenance HD\u2009\u2265\u200990\u2009days were screened using the malnutrition\u2013inflammation score (MIS; high risk &gt;\u20095), SARC\u2010F (sarcopenia risk \u2265\u20094) high risk, calf circumference (CC; cut\u2010offs \u2264\u200934\u2010cm males, \u2264\u200933\u2010cm females), CC adjusted for body mass index (BMI) and oedema (Adj. CC) and SARC\u2010CalF (sarcopenia risk \u2265\u200911). SO was defined as sarcopenia risk by SARC\u2010CalF (Adj. CC) plus BMI\u2009&gt;\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Routine blood chemistry (e.g., total iron\u2010binding capacity [TIBC] and albumin) and screening tools were collected for physical function (Karnofsky), falls risk (Morse fall) and comorbidity (Charlson index). Univariate and multivariate logistic regression (adjusted for age, sex, diabetes, dialysis vintage and Kt\/V) identified factors associated with each outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 3722 HD patients (56.8% male; age 53.6\u2009\u00b1\u200915.8\u2009years; BMI 26.8\u2009\u00b1\u20096.4\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), 48% had diabetes and 35% had high\/very high Charlson comorbidity index. High nutritional risk (MIS\u2009&gt;\u20095) was found in 44.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091657) and sarcopenia risk (SARC\u2010CalF [Adj. CC]) in 53.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091978); 31.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091175) had combined malnutrition and sarcopenia (M\u2009+\u2009S) and 7.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009285) had SO. Versus the no\u2010risk group, M\u2009+\u2009S patients had lower albumin, TIBC, Karnofsky score and higher comorbidity index and Morse fall risk score (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Independent factors associated with high nutritional risk included lower BMI, higher Charlson index, longer dialysis vintage, lower serum creatinine and higher triglycerides (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Shared independent factors for sarcopenia risk were older age, higher comorbidity index, longer dialysis duration, lower creatinine and higher triglycerides (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first large\u2010scale study to fully characterise a Saudi and Middle Eastern HD cohort. There was a very high risk of malnutrition and sarcopenia. Furthermore, a high number had both conditions and overlapping features of PEW\/cachexia, which included high comorbidity and disability risk. Findings support routine, multitool nutritional and muscle screening in HD care, including younger patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70386","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:46:36Z","timestamp":1790657196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Overlap of Malnutrition, Sarcopenia and Related Nutritional Syndromes in a Large Haemodialysis Population"],"prefix":"10.1002","volume":"17","author":[{"given":"Hanaa","family":"Noor","sequence":"first","affiliation":[{"name":"Diaverum  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhashini","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Insights Research Organization and Solutions (IROS)  Abu Dhabi UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia Martinez","family":"Cantarutti","sequence":"additional","affiliation":[{"name":"Insights Research Organization and Solutions (IROS)  Abu Dhabi UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Diaverum  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imed","family":"Helal","sequence":"additional","affiliation":[{"name":"Diaverum  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Reid","sequence":"additional","affiliation":[{"name":"School of Midwifery and Nursing Queen's University Belfast  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Slee","sequence":"additional","affiliation":[{"name":"Division of Medicine, Faculty of Medical Sciences University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"e342","DOI":"10.1016\/S2214-109X(24)00050-0","article-title":"The Major Global Burden of Chronic Kidney Disease","volume":"12","author":"Jadoul M.","year":"2024","journal-title":"Lancet Global Health"},{"issue":"1","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-025-03954-2","article-title":"Prevalence of Chronic Kidney Disease in Saudi Arabia: An Epidemiological Population\u2010Based Study","volume":"26","author":"Alshehri M. 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