Identification of sarcopenia and dynapenia in CKD predialysis patients with EGWSOP2 criteria: An observational, cross-sectional study

Guida, Bruna; Maro, Martina Di; Lauro, Mariastella Di; Lauro, Teresa Di; Trio, Rossella; Santillo, Mariarosaria; Belfiore, A.; Memoli, Andrea; Cataldi, Mauro

doi:10.1016/j.nut.2020.110815

Cited by 15 publications

(14 citation statements)

References 28 publications

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“…Low albumin is often used as a biochemical marker of malnutrition and poor nutritional status, which may result in protein synthesis degradation and muscle weakness 52 . We observed that sarcopenic participants had lower serum albumin, supporting previous research in older adults 52 and in patients with CKD, 21 although absolute differences in albumin between sarcopenic and non‐sarcopenia patients were small. We saw no association between with sarcopenia and the weekly meat intake (a crude surrogate for increased dietary protein), although detailed investigation of macronutrients may provide a better understanding of the role of diet in sarcopenia.…”

Section: Discussionsupporting

confidence: 87%

“…found probable sarcopenia was evident in 63% of patients, with confirmed sarcopenia in 24%. Guida et al 21 . found the prevalence of sarcopenia and dynapenia (low HGS) was, respectively, 7.1% and 17.6% in 85 patients.…”

Section: Discussionmentioning

confidence: 98%

“…This is likely due to a lack of sarcopenia recognition and assessment in UK healthcare organizations 8 . In studies of non‐dialysis CKD, sarcopenia prevalence estimates range widely from 6% to 19% 12,13,15,20,21,34,35 . However, the ability to compare studies is greatly limited by the diverse definitions employed.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of sarcopenia in non‐dialysis CKD patients are limited by low sample sizes, lack of control group, and inconsistent use of definitions 12,21–23 The aims of this study were to (i) identify the prevalence of sarcopenia in a large cohort of individuals with CKD; (ii) identify the risk factors of sarcopenia in those with CKD; and (iii) explore the association of sarcopenia with all‐cause mortality and progression to ESRD.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with end‐stage renal disease (ESRD) and on dialysis, sarcopenia has a prevalence of between 20% and 55% 14–18 and is associated with an increased mortality risk 13,14,16,18,19 . However, the prevalence in earlier non‐dialysis CKD stages is less well‐defined, and the association with unfavourable outcomes is poorly understood 9,12,20,21 . Given that sarcopenia characteristics (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Wilkinson

Miksza

Yates

et al. 2021

J cachexia sarcopenia muscle

102

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Background Sarcopenia, a degenerative and generalized skeletal muscle disorder involving the loss of muscle function and mass, is an under‐recognized problem in clinical practice, particularly in chronic kidney disease (CKD). We aimed to investigate the prevalence of sarcopenia in individuals with CKD, its risk factors, and its association with all‐cause mortality and progression to end‐stage renal disease (ESRD). Methods UK Biobank participants were grouped according to the presence of CKD (defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2) and as having probable (low handgrip strength), confirmed (plus low muscle mass), and severe sarcopenia (plus poor physical performance) based on the 2019 European Working Group of Sarcopenia in Older People and Foundation for the National Institutes of Health criteria. Risk factors were explored using logistic regression analysis. Survival models were applied to estimate risk of mortality and ESRD. Results A total of 428 320 participants, of which 8767 individuals with CKD (46% male, aged 62.8 (standard deviation 6.8) years, median estimated glomerular filtration rate 54.5 (interquartile range 49.0–57.7) mL/min/1.72 m2) were included. Probable sarcopenia was present in 9.7% of individuals with CKD compared with 5.0% in those without (P < 0.001). Sarcopenia was associated with being older; inflammation; poorer renal function; and lower serum albumin, total testosterone, and haemoglobin. The largest risk factors for sarcopenia were having three or more comorbidities (odds ratio: 2.30; 95% confidence interval: 1.62 to 3.29; P < 0.001) and physical inactivity: participants in the highest quartile of weekly activity were 43% less likely to have sarcopenia compared to the lowest quartile (odds ratio: 0.57; 0.42 to 0.76; P < 0.001). Participants with CKD and sarcopenia had a 33% (7% to 66%; P = 0.011) higher hazard of mortality compared with individuals without. Sarcopenic CKD individuals had a 10 year survival probability of 0.85 (0.82 to 0.88) compared with 0.89 (0.88 to 0.30) in those without sarcopenia, an absolute difference of 4%. Those with sarcopenia were twice as likely to develop ESRD (hazard ratio: 1.98; 1.45 to 2.70; P < 0.001). Conclusions Participants with reduced kidney function are at an increased risk of premature mortality. The presence of sarcopenia increases the risk of mortality and ESRD. Appropriate measurement of sarcopenia should be used to identify at‐risk individuals. Interventions such as physical activity should be encouraged to mitigate sarcopenia.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Wilkinson

Miksza

Yates

et al. 2021

J cachexia sarcopenia muscle

102

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Frailty in kidney transplant candidates: a comparison between physical frailty phenotype and FRAIL scales

et al. 2022

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Prevalence and determinants of sarcopenia in Indian patients with chronic kidney disease stage 3 & 4

Dubey

Sahoo

Vairappan

et al. 2021

Osteoporosis and Sarcopenia

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Objectives There is limited literature on the prevalence and determinants of sarcopenia in the Indian predialysis chronic kidney disease (CKD) population. The current study attempts to characterize sarcopenia in CKD stages 3 & 4 using 3-compartment model dual-energy X-ray absorptiometry (DXA). Methods This is secondary data from a randomized trial on bicarbonate supplementation for preserving muscle mass. A 3-compartment DXA was done to assess body composition in 188 subjects aged 18 to 65, with stable kidney function. Sarcopenia was defined by Asian Working Group criteria - appendicular skeletal mass index < 5.4 kg/m 2 in women and < 7 kg/m 2 in men. Results Sarcopenia was present in 69.1% (n = 130). There was no difference in the prevalence of sarcopenia in CKD stage 3 (n = 62; 72.1%) vs CKD stage 4 (n = 68, 66.7%); P = 0.434. A lower body mass index (BMI) (OR 1.69; 95% CI 1.43, 2.01) and lower bicarbonate levels (OR 1.22; 95% CI 1.02, 1.47), and age (OR 0.95; 95% CI 0.91, 0.98) was independently associated with the muscle mass. A BMI cut-off of 18 failed to identify sarcopenia in 78.4% (n = 102) subjects (Kappa statistic 0.396). The receiver operating characteristic curve for mid-arm muscle circumference for identifying sarcopenia was 0.651 (95% CI 0.561, 0.740). Conclusions Sarcopenia is highly prevalent in CKD 3 and 4. Sarcopenic individuals are older, with a low BMI and lower bicarbonate levels. The anthropometric parameters and biochemical parameters did not help identify sarcopenia in the predialysis population.

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Identification of sarcopenia and dynapenia in CKD predialysis patients with EGWSOP2 criteria: An observational, cross-sectional study

Cited by 15 publications

References 28 publications

Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Frailty in kidney transplant candidates: a comparison between physical frailty phenotype and FRAIL scales

Prevalence and determinants of sarcopenia in Indian patients with chronic kidney disease stage 3 & 4

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