Sarcopenia can be easily observed in patients with hemodialysis. However, there were few studies on the precise concept and diagnostic criteria for sarcopenia in patients with hemodialysis. The investigators have already recognized the sarcopenia-associated mortality and morbidity in patients with hemodialysis. However, intervention studies on hemodialysis patients with sarcopenia have not been conducted until now. In 2021, the investigators conducted a pilot study to evaluate the effectiveness of the combined exercise and nutrition intervention for sarcopenia in patients with hemodialysis to confirm the effectiveness. This study is a follow-up study, conducted as a randomized controlled trial.
Patients with hemodialysis
Community-dwellers
Able to walk with or without assistive devices for more than 100 meters
A person with cancer disease.
People with psychiatric symptoms.
A person who has an absorption disorder or has a history of resection of the small intestine or colon
Pregnant women
Parallel
exercise and nutritional support
Other interventionresistance exercise and protein supplementation including branched chain amino acids for 12 weeks
Handgrip strength in Kg using a portable dyanometer
Measurement of handle strength using a portable dynamometer to view the function of skeletal muscle every 4 weeks.
Body composition using dual energy x-ray absorptiometry (DXA)
Body composition will be evaluated by dual energy x-ray absorptiometry at start and end of the study.
Body composition using body composition monitor (BCM)
Body composition will be evaluated by bioimpedence analysis using body composition monitor start at and end of the study.
The total score of Short Physical Performance Battery(SPPB)
The total score is the sum of 5 times Chair Stand Test(CST) score and balance test score and gait speed test score for 4meter.
The second of 5 times Chair Stand Test
Pre test, participants fold their arms across their chest and try to stand up once from a chair. And Measures the time required to perform five rises from a chair to an upright position as fast as possible without the use of the arms.
skeletal muscle mass index(SMI) in cm2/m2
The SMI was calculated according to the following formula: skeletal muscle mass (cm 2) / height 2 (m 2).
Glucose pattern using continuous glucose monitoring system(freestyle libre)
Blood glucose is measured using continuous glucose monitoring system(freestyle libre) at start and end of the study.
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