Prevalence of sarcopenia in kidney transplants and their association with determinant factors of muscle homeostasis

Abstract

SUMMARY INTRODUCTION: Sarcopenia is characterized by the involuntary loss of lean body mass associated with a progressive reduction of muscle strength. OBJECTIVE: To determine the prevalence of sarcopenia in kidney transplant recipients and its association with the determining factors that control muscle homeostasis. METHODS: We evaluated renal transplant recipients undergoing follow-up at the University Hospital of the Federal University of Maranhão from June 2017 to July 2018 and who met the inclusion criteria. Sarcopenia was defined according to the European criteria. The skeletal muscle mass index was measured by dual-energy radiological absorptiometry; the values <7,26 kg/m2 for men and <5,5 kg/m2 for women were adopted for muscle depletion. For handgrip strength, values of <30 kg for men and <20 kg for women were considered as reduced muscle strength. In both sexes, the cutoff point for walking speed was <0,8 m/s. RESULTS: We evaluated 83 renal transplant recipients with a mean age of 48.8 ± 12,1 years and predominantly males (57,8%). The prevalence of sarcopenia was 19,3%. Among individuals without sarcopenia, 17,9% had a decrease in handgrip strength and 40,3% has altered gait speed. DISCUSSION: Individuals submitted to renal transplant may develop sarcopenia while still young and already present altered muscle function and strength even before the depletion of lean body mass. CONCLUSION: Early diagnosis may allow the prevention of sarcopenia and provide a better quality of life for patients.

Diagnosis, prevalence, and outcomes of sarcopenia in kidney transplantation recipients: A systematic review and meta‐analysis

“…Out of these, 20 studies were excluded for reasons detailed in Table S2 . Finally, 23 6 , 7 , 8 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 studies were included, involving 2535 KTRs with 59.7% of male subjects. Of these, nine studies were from Europe, seven were from Asia, five were from South America, one was from North America, and one was from Oceania.…”

A razão neutrófilos-linfócitos e as concentrações da proteína C-reativa não são associados à força, massa muscular e capacidade funcional de pacientes transplantados renais

“…Interestingly, working on that same population, our group recently observed that approximately 19% of KTPs who attended an outpatient clinic suffered from sarcopenia [48]. In addition, a couple of recent cross-sectional studies have demonstrated important findings as to the prevalence of sarcopenia and poor prognosis based on its components in KTPs [31,32]. In one study, 11% of a sample consisting of 210 KTPs had sarcopenia [31], and 19% of 83 KTPs in the other [32].…”

“…In one study, 11% of a sample consisting of 210 KTPs had sarcopenia [31], and 19% of 83 KTPs in the other [32]. Regarding the latter, among individuals without sarcopenia, 18% had a decrease in HGS and 40% in altered gait speed, hence indicating that an individual evaluation of sarcopenia components should be taken into consideration as well [32].…”

“…In addition, a couple of recent cross-sectional studies have demonstrated important findings as to the prevalence of sarcopenia and poor prognosis based on its components in KTPs [31,32]. In one study, 11% of a sample consisting of 210 KTPs had sarcopenia [31], and 19% of 83 KTPs in the other [32]. Regarding the latter, among individuals without sarcopenia, 18% had a decrease in HGS and 40% in altered gait speed, hence indicating that an individual evaluation of sarcopenia components should be taken into consideration as well [32].…”

“…More specifically, the CRP is a well-understood marker of acute inflammatory process caused by acute infections and chronic low-grade inflammation when measured via high-sensitivity assay [25][26][27], while NLR has been evoked as a routinely available and cost-effective measure of systemic inflammation derived from the absolute neutrophil and absolute lymphocyte counts of a full blood count [28][29][30]. In the face of the use of these markers in ubiquitous clinical situations, a more detailed understanding of their association with the components of sarcopenia are pivotal in order to elucidate underlying mechanisms related to muscle wasting in KTPs, given that only a handful of research has explored this subject matter [31,32]. Thus, the purpose of this study was to ascertain whether or not NLR and CRP levels are associated with the components of sarcopenia in KTPs.…”