Abstract: Objective To investigate the current status of intrinsic capacity(IC) and its correlation with body composition in the elderly patients undergoing maintenance hemodialysis(MHD). Methods The elderly outpatients receiving regular dialysis at the Blood Purification Center of Zhongda Hospital, Southeast University from July to September 2024 were enrolled in this study. IC was assessed on the day of dialysis, and body composition analysis was performed after dialysis on the same day. Multivariate logistic regression analysis was used to identify the influencing factors of IC decline. R software was employed to construct a nomogram of risk prediction model for IC decline in the elderly MHD patients. Internal validation was conducted using the enhanced Bootstrap method and a validation set, and the predictive performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC) and calibration curve. Results A total of 133 elderly MHD patients were enrolled with 22 cases presenting with good IC, and 111 cases presenting with poor IC. The elderly MHD patients with poor IC had a higher edema index (extracellular water/total body water), fat tissue index (FTI), and lower skeletal muscle index (SMI) and phase angle (PA), compared with those in the elderly MHD patients with good IC (P<0.05). Multivariate logistic regression analysis showed that increased age, decreased SMI, and decreased albumin were independent risk factors for IC decline in the elderly MHD patients. The AUC of the training set was 0.94 (95%CI: 0.90-0.97), with a sensitivity of 83% and a specificity of 90%. Conclusions The elderly MHD patients, as a special group living with long-term diseases, are at high risk of IC decline. Age, SMI, and albumin are independent risk factors affecting IC in the elderly MHD patients. Formulating targeted comprehensive intervention strategies is of great clinical significance for improving the quality of life and prognosis of the elderly MHD patients.

Key words: aged, hemodialysis, body composition, skeletal muscle index, intrinsic capacity