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

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 accuracy, health-related quality of life (HRQoL), and instrumental activities of daily living (IADL). 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 based on the Evans criteria were also identified as having the condition based on the AWGC criteria. The AWGC criteria demonstrated superior diagnostic accuracy (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 In contrast to the Evans criteria, the AWGC criteria demonstrated high validity and superior applicability 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.