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Background <p>Cachexia worsens the long-term prognosis of patients with chronic kidney disease (CKD) undergoing hemodialysis. The Asian Working Group for Cachexia (AWGC) has proposed diagnostic criteria tailored to Asian populations. In this study, we aimed to validate the AWGC criteria for diagnosing cachexia in patients with CKD undergoing hemodialysis by focusing on the prevalence, diagnostic agreement, health-related quality of life (HRQoL), and instrumental activities of daily living (IADL) in comparison with the Evans criteria.</p> Methods <p>This cross-sectional study included 93 outpatients with CKD undergoing hemodialysis. Cachexia was diagnosed using the AWGC and Evans criteria. HRQoL was assessed using the European Quality of Life 5 Dimensions 5-level (EQ-5D-5L), and IADL was evaluated using the Lawton IADL scale. Statistical analyses included evaluation of sensitivity and specificity and multiple regression to examine the associations of cachexia definitions with HRQoL, and IADL.</p> Results <p>Cachexia prevalence was 30.1% and 24.7% according to the AWGC and Evans criteria, respectively. All patients diagnosed with cachexia on the basis of the Evans criteria were also identified as having the condition based on the AWGC criteria. The AWGC criteria demonstrated a high level of agreement with the Evans criteria (<i>κ</i> = 0.865), with a sensitivity of 1.000 and specificity of 0.929. Associations of cachexia (as defined by each criterion) with HRQoL and IADL were similar.</p> Conclusions <p>The AWGC criteria demonstrated clinical validity comparable to that of the Evans criteria, offering superior practical feasibility for diagnosing cachexia in outpatients with CKD undergoing hemodialysis. These findings highlight the practicality of the AWGC criteria. Their use may facilitate early detection and help prevent cachexia progression, thereby improving patient outcomes.</p>

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Validity of cachexia diagnosed using AWGC criteria in outpatients with chronic kidney disease undergoing hemodialysis: a cross-sectional study

  • 期刊论文

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  • 发表日期：

    2026年6月15日

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  • Takuma Yagi,
  • Tatsuro Inoue,
  • Masato Ogawa,
  • Masatsugu Okamura,
  • Kengo Shirado,
  • Nobuyuki Shirai,
  • Shuji Konishi,
  • Takashi Koshiba,
  • Yuichiro Ishigaki,
  • Yasunori Heguri,
  • Naoki Tanimiya,
  • Risa Okada,
  • Shinichi Nishi

摘要

Background

Cachexia worsens the long-term prognosis of patients with chronic kidney disease (CKD) undergoing hemodialysis. The Asian Working Group for Cachexia (AWGC) has proposed diagnostic criteria tailored to Asian populations. In this study, we aimed to validate the AWGC criteria for diagnosing cachexia in patients with CKD undergoing hemodialysis by focusing on the prevalence, diagnostic agreement, health-related quality of life (HRQoL), and instrumental activities of daily living (IADL) in comparison with the Evans criteria.

Methods

This cross-sectional study included 93 outpatients with CKD undergoing hemodialysis. Cachexia was diagnosed using the AWGC and Evans criteria. HRQoL was assessed using the European Quality of Life 5 Dimensions 5-level (EQ-5D-5L), and IADL was evaluated using the Lawton IADL scale. Statistical analyses included evaluation of sensitivity and specificity and multiple regression to examine the associations of cachexia definitions with HRQoL, and IADL.

Results

Cachexia prevalence was 30.1% and 24.7% according to the AWGC and Evans criteria, respectively. All patients diagnosed with cachexia on the basis of the Evans criteria were also identified as having the condition based on the AWGC criteria. The AWGC criteria demonstrated a high level of agreement with the Evans criteria (κ = 0.865), with a sensitivity of 1.000 and specificity of 0.929. Associations of cachexia (as defined by each criterion) with HRQoL and IADL were similar.

Conclusions

The AWGC criteria demonstrated clinical validity comparable to that of the Evans criteria, offering superior practical feasibility for diagnosing cachexia in outpatients with CKD undergoing hemodialysis. These findings highlight the practicality of the AWGC criteria. Their use may facilitate early detection and help prevent cachexia progression, thereby improving patient outcomes.