AB0911 Sarcopenia Assessment in Chronic Kidney Disease Patients

Abstract

BackgroundSarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death. Uremic sarcopenia causes a high morbidity and mortality and consequently a high priority for muscle wasting prevention and treatment in these patients.ObjectivesTo assess sarcopenia (muscle state and power) in CKD patients with & without hemodialysis.MethodsIn this study there were three studied groups: Group I: 20 CKD patients on regular hemodialysis. Group II: 20 CKD patients on conservative treatment. Group III: 20 normal persons. After informed consent all patients recruited from dialysis unit, inpatient and outpatient clinics of Internal Medicine Department at Ain Shams University Hospital. Diabetic, patients with hemoglobin ≤10 g/dl, aged ≥50 years or have chronic diseases that may cause secondary sarcopenia had been excluded from the study. All subjected to full medical history and clinical examination. The muscle power assessed using the hand grip dynamometer1, physical performance through using 4 Meter Walk Gait Speed Test2. CBC, serum creatinine, BUN, serum electrolytes & PTH. Dual-energy X-ray absorptiometry (DEXA)3 was used to assess bone loss and total body mass loss (lean mass, fat mass, BMD). Assessment of nutritional status by using subjective global assessment (SGA) score4.ResultsThere is high significant positive correlation between age and 4 meter walk test. Group I & II had a higher mean time of 4 meter walk test & weaker hand grip strength compared to the control. There is positive correlation between 4 meter walk test and SGA score & clinical symptoms of sarcopenia (asthenia, easy fatigability, weakness & muscle cramps), negative correlation with hand grip strength. Also there is positive correlation between hand grip strength with lean mass & BMD and negative correlation with clinical symptoms of sarcopenia, fat mass & SGA score. There is negative correlation between SGA score with lean mass, fat mass & BMD. 4 meter walk test is the most specific & sensitive test to diagnose sarcopenia in CKD patients.ConclusionsSarcopenia was present in CKD patients with hemodialysis more than without hemodialysis than normal people. Asthenia, weakness, easy fatigability & cramps are warning symptoms for sarcopenia. 4 meter walk test was the most specific & sensitive test to assess sarcopenia in CKD patients.ReferencesTaekema DG, Gussekloo J, Maier AB, et al. Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing 2010; 39: 331–7.Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000; 55: M221–31.Bijlsma AY, Meskers CG, Ling CH, et al. Defining sarcopenia: the impact of different diagnostic criteria ...

Dampak Frekuensi Pernapasan Predialisis Terhadap Kram Otot Intradialisis Di Rsud Panembahan Senopati Bantul

“…Perpindahan cairan dari tubuh ke tabung dialisat, dan sebaliknya inilah yang memicu adanya stress oksidatif, sehingga otot menjadi kekurangan energi khususnya dalam bentuk ATP (adenosit triphospat). Sel otot bekerja melalui system biologis metabolis, yang memberi respon terhadap aktivitas kimia, listrik, maupun mekanik (Behringer, et al, 2014;El-Azizi, et al, 2016). Energi dalam bentuk ATP yang dibutuhkan untuk aktivitas otot dibentuk melalui proses metabolisme glukosa pada siklus krebs (S.A.M., et al, 2013;Reilly, et al, 2015).…”

“…Saat oksigenasi predialisis adekuat, maka cadangan oksigenasi yang dapat digunakan untuk energy seluler pun masih adekuat, sehingga otot masih dapat energi melalui metabolisme aerob, dengan demikian produksi asam laktat sebagai hasil akhir dari metabolisme anaerob akan lebih sedikit terbentuk. Kondisi ini tentunya juga akan mengurangi ri-siko munculnya keluhan kram otot selama proses hemodialisis berlangsung (El-Azizi, et al, 2016;Watanabe, et al, 2015).…”