A Sarcopenia Index Derived from Malnutrition Parameters in Elderly Haemodialysis Patients

Sánchez-Tocino, Maria Luz; Mas, Sebastián; Gracia-Iguacel, Carolina; Pereira, Mónica; González-Ibarguren, I.; Ortíz, Alberto; Arenas, María Dolores; Parra, Emilio González

doi:10.3390/nu15051115

Cited by 4 publications

(1 citation statement)

References 61 publications

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“…A clinical study found that the elderly hemodialysis sarcopenia index (EHSI) can identify sarcopenia diagnosed by the European Working Group on Sarcopenia in Older People (EWGSOP) second meeting using easily accessible anthropometric and nutritional parameters. A combination of gender, age, serum albumin, phosphate, and cholesterol can effectively predict the severity of sarcopenia [179]. The current nutritional therapy for uremic sarcopenia includes oral supplements, parenteral nutrition, enteral nutrition, high protein and fiber diet, and gastrectomy [180].…”

Section: Other Possible Therapeutic Strategiesmentioning

confidence: 99%

The Potential Influence of Uremic Toxins on the Homeostasis of Bones and Muscles in Chronic Kidney Disease

et al. 2023

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Patients with chronic kidney disease (CKD) often experience a high accumulation of protein-bound uremic toxins (PBUTs), specifically indoxyl sulfate (IS) and p-cresyl sulfate (pCS). In the early stages of CKD, the buildup of PBUTs inhibits bone and muscle function. As CKD progresses, elevated PBUT levels further hinder bone turnover and exacerbate muscle wasting. In the late stage of CKD, hyperparathyroidism worsens PBUT-induced muscle damage but can improve low bone turnover. PBUTs play a significant role in reducing both the quantity and quality of bone by affecting osteoblast and osteoclast lineage. IS, in particular, interferes with osteoblastogenesis by activating aryl hydrocarbon receptor (AhR) signaling, which reduces the expression of Runx2 and impedes osteoblast differentiation. High PBUT levels can also reduce calcitriol production, increase the expression of Wnt antagonists (SOST, DKK1), and decrease klotho expression, all of which contribute to low bone turnover disorders. Furthermore, PBUT accumulation leads to continuous muscle protein breakdown through the excessive production of reactive oxygen species (ROS) and inflammatory cytokines. Interactions between muscles and bones, mediated by various factors released from individual tissues, play a crucial role in the mutual modulation of bone and muscle in CKD. Exercise and nutritional therapy have the potential to yield favorable outcomes. Understanding the underlying mechanisms of bone and muscle loss in CKD can aid in developing new therapies for musculoskeletal diseases, particularly those related to bone loss and muscle wasting.

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Section: Other Possible Therapeutic Strategiesmentioning

confidence: 99%

The Potential Influence of Uremic Toxins on the Homeostasis of Bones and Muscles in Chronic Kidney Disease

et al. 2023

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Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine

Treuil,

Mahmutovic,

Di Patrizio

et al. 2023

Clinical Nutrition ESPEN

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The association of appendicular skeletal muscle mass with anthropometric, body composition, nutritional, inflammatory, and metabolic variables in non-dialysis-dependent chronic kidney disease men

Romejko,

Szamotulska,

Rymarz

et al. 2024

Front. Med.

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BackgroundMuscle atrophy affects more than 50% of patients with chronic kidney disease (CKD) and is associated with increased morbidity and mortality. It is crucial to understand the mechanisms involved in the muscle atrophy in CKD and search for specific determinants of skeletal muscle mass loss, especially those which are available in everyday medical practice. This study aimed to evaluate the association between appendicular skeletal muscle mass (ASM) and anthropometric, body composition, nutritional, inflammatory, metabolic, and kidney function variables in non-dialysis-dependent CKD men.MethodsA total of 85 men with CKD and eGFR lower than 60 mL/min/1.73 m2 were included in the cross-sectional study: 24 participants with eGFR 59–45 mL/min/1.73 m2, 32 individuals with eGFR 44–30 mL/min/1.73 m2, and 29 men with eGFR ≤29 mL/min/1.73 m2. ASM was estimated by bioimpedance spectroscopy (BIS) with the use of a Body Composition Monitor (BCM). To evaluate ASM from BCM, Lin’s algorithm was used. Among anthropometric parameters, height, weight, and body mass index (BMI) were measured. Serum laboratory measurements were grouped into kidney function, nutritional, inflammatory, and metabolic parameters.ResultsASM was significantly associated with anthropometric and body composition variables. According to the anthropometric parameters, ASM correlated positively with weight, height, and BMI (p < 0.001 and r = 0.913, p < 0.001 and r = 0.560, and p < 0.001 and r = 0.737, respectively). Among body composition variables, ASM correlated significantly and positively with lean tissue mass (LTM) (p < 0.001, r = 0.746), lean tissue index (LTI) (p < 0.001, r = 0.609), fat mass (p < 0.001, r = 0.489), and fat tissue index (FTI) (p < 0.001, r = 0.358). No other statistically significant correlation was found between ASM and kidney, nutritional, metabolic, and inflammatory variables.ConclusionIn male patients with CKD stages G3–G5 not treated with dialysis, ASM correlates significantly and positively with anthropometric and body composition parameters such as weight, height, BMI, LTM, LTI, fat mass, and FTI. We did not observe such relationship between ASM and kidney function, nutritional, metabolic, and inflammatory variables.

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A Sarcopenia Index Derived from Malnutrition Parameters in Elderly Haemodialysis Patients

Cited by 4 publications

References 61 publications

The Potential Influence of Uremic Toxins on the Homeostasis of Bones and Muscles in Chronic Kidney Disease

The Potential Influence of Uremic Toxins on the Homeostasis of Bones and Muscles in Chronic Kidney Disease

Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine

The association of appendicular skeletal muscle mass with anthropometric, body composition, nutritional, inflammatory, and metabolic variables in non-dialysis-dependent chronic kidney disease men

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