Banca de DEFESA: Marvery Peterson Pinheiro Duarte

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Marvery Peterson Pinheiro Duarte
DATE: 01/12/2025
TIME: 08:30
LOCAL: Faculdade de Ciências da Saúde - UnB - SALA DE REUNIÃO 01
TITLE:

SARCOPENIA IN PATIENTS ON HEMODIALYSIS: TRAJECTORIES, DETERMINANTS, AND PROGNOSIS FROM THE SARC-HD COHORT

KEY WORDS:

“sarcopenia, chronic kidney disease, hemodialysis, epidemiology, muscle strength, physical performance, SARC-HD, disease trajectory”

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

“Sarcopenia, characterized by the progressive loss of physical function and muscle mass, is highly prevalent and associated with increased mortality in patients with chronic kidney disease on hemodialysis. However, its trajectories and determinants over time remained poorly understood. Therefore, this thesis aimed to investigate the trajectory of sarcopenia and its determinants in patients with chronic kidney disease on hemodialysis, through eight original studies from the multicenter SARC-HD cohort. In the first study, we published the methodological protocol, meeting the growing demand of high-impact journals and ensuring scientific transparency and reproducibility. In the second, through a qualiquantitative analysis, we detailed the cohort's recruitment and implementation process, revealing unique logistical challenges and effective strategies for conducting multicenter research in Brazilian dialysis centers. In the third study, we characterized the epidemiological profile of the patients included in the cohort, demonstrating a high prevalence and clinical and functional risk factors in our sample. In the fourth study, we proposed novel reference values for handgrip strength, the five-repetition sit-to-stand test, and the usual 4-meter walking speed in this population, filling a critical gap for the accurate diagnosis of functional impairment. In the fifth, we identified that dynapenia (i.e., low muscle strength) is associated with higher levels of self-reported fatigue, underscoring the importance of functional markers in stratifying debilitating clinical symptoms. In the sixth study, we further demonstrated that the application of different diagnostic consensuses (EWGSOP2 and SDOC) results in only moderate agreement, alerting to significant variations in the estimated prevalence of sarcopenia. The seventh study, conducted during a doctoral internship at the University of Maia (Portugal), revealed that diabetes mellitus is independently associated with sarcopenia, with a modulating effect of biological sex, the association being stronger in men. Finally, in the eighth study of this thesis, the prospective investigation of trajectories over 12 months represented a central milestone, revealing a dynamic and bidirectional course of sarcopenia, with cases of progression and regression of stages. These trajectories were independently associated with a multifactorial set of determinants, including advanced age, male sex, white ethnicity, having a partner, multimorbidity, being physically active, and having overweight/obesity in patients on hemodialysis. Analyzed collectively, the findings reported in this thesis demonstrate that sarcopenia in patients on hemodialysis is a complex and non-static phenomenon, whose bidirectional nature demands continuous longitudinal monitoring. Our findings provide novel diagnostic tools, clarify modifiable risk factors, and reshape the understanding of the disease's natural history, with direct implications for risk stratification and the development of personalized and timely intervention strategies in this atrisk population.”

COMMITTEE MEMBERS:
Externa à Instituição - LILIANE VIANA PIRES - UFS
Externa à Instituição - NARA ALINE COSTA - UFG
Presidente - 2376346 - OTAVIO DE TOLEDO NOBREGA
Externo ao Programa - 1794344 - RICARDO MORENO LIMA - nullExterna ao Programa - 1962055 - RITA DE CASSIA MARQUETI DURIGAN - null