Performance of the SARC-F (Strength, Assistance Walking, Rise From a Chair, Climb Stairs, and Falls) Questionnaire for Sarcopenia Screening in Patients With End-Stage Renal Disease on Hemodialysis.

INTRODUCTION: The systematic screening of sarcopenia among patients with end-stage renal disease (ESRD) on hemodialysis (HD) has emerged as a critical component of comprehensive patient assessment and management. The SARC-F (Strength, Assistance walking, Rise from a chair, Climb stairs, and Falls) is a simple and widely used tool for sarcopenia screening across multiple populations; however, its diagnostic performance in HD remains uncertain. We aimed to evaluate the diagnostic performance of the SARC-F questionnaire for sarcopenia screening in HD patients. METHODS: Cross-sectional diagnostic accuracy study in Mexican patients with ESRD on HD. Sarcopenia was defined according to European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria: appendicular muscle mass, handgrip strength, and gait speed. The Spanish version of the SARC-F validated for Mexico was used; cut-off >4 points. Sensitivity, specificity, predictive values, receiver operating characteristic (ROC) curve, and area under the curve (AUC) were estimated. RESULTS: Ninety-four patients were included (62.8% men; mean age 54±14 years). Sarcopenia prevalence was 8.5%. SARC-F >4 was observed in 17%. Diagnostic performance was poor: AUC 0.40 (95%CI 0.16-0.63; p=0.35), sensitivity 13% (95%CI, 2.2-47.1%), specificity 83% (95%CI, 73.2-89.1%), positive predictive value 6% (95%CI, 1.1-28.3%), and negative predictive value 91% (95%CI 82.6-95.6%). CONCLUSIONS: SARC-F showed poor diagnostic performance in HD patients. Its high specificity and negative predictive value suggest utility to rule out sarcopenia; combining SARC-F with objective measures of muscle mass and performance is recommended for more accurate screening.