Thumb adductor muscle thickness used in the nutritional assessment of chronic kidney disease patients under conservative treatment

Abstract

Introduction: Evaluate the association between the thumb adductor muscle thickness and the patient's nutritional status, and propose cutoff points for muscle mass depletion in elderly patients with chronic kidney disease (CKD) under conservative treatment. Epidemiological and cross-sectional study, including patients with CKD stages 3 to 5, older than 60 years. Socioeconomic, clinical, physical activity and anthropometric data was obtained. TAMT was described and compared according to CKD stage, socioeconomic data, physical activity, nutritional status and correlated with age, glomerular filtration rate and anthropometric variables. Receiver Operating Characteristic (ROC) curves were produced, considering the lean tissue index classification as reference. The cut-off point was defined by the Youden index. Results: We evaluated 137 individuals. The TAMT was lower in malnourished and/or depleted muscle mass individuals; among males it was higher among those who practiced physical activities (p <0.05). This measure was moderately correlated with BMI, calf and brachial circumferences, lean body tissue, lean tissue index and body cell mass (r <0.7); negatively with age (r = -0.34). The ROC curve analysis determined cut points of 15.33 mm for females and 20.33 mm for males, with 72.22% and 62.50% accuracy, respectively. Conclusion: TAMT is used to estimate muscle mass and we suggest the cutoff point is useful to rule out the likelihood of muscle mass depletion. It is recommended that it be used in a complementary way in nutritional assessment.

Clinical practice guideline exercise and lifestyle in chronic kidney disease

“…Research to date has focussed on the effect of physical activity and exercise interventions on muscle mass, muscle strength and physical capacity. Relating to muscle mass, to date of the 14 studies which sought to investigate the effect of differing exercise interventions, 6 reported a positive effect on muscle mass [ 24 – 26 ] or muscle volume [ 27 ] with a mix of high and low risk of bias, with 10 of these studies being RCTs in design. Of the RCTs, 8 studies contained an aerobic training element with 38% (3/8 studies) reporting beneficial effects of aerobic training on muscle mass or a surrogate marker of muscle mass (ie.…”

Pruebas para el diagnóstico nutricional en pacientes con enfermedad renal crónica: una revisión narrativa

“…Pereira P y colaboradores (37) realizaron un estudio cuyo objetivo fue evaluar la asociación del grosor del músculo aductor del pulgar (TAMT) con el estado nutricional y proponer puntos de corte para la evaluación de la depleción de masa muscular en pacientes ancianos con ERC en tratamiento conservador. El TAMT se midió con el individuo sentado, con las manos relajadas y sobre las rodillas, y los brazos apoyados en los muslos, con el codo en flexión de 90° aproximadamente.…”

“…Pereira P y colaboradores (37) En todos los pacientes se evaluaron medidas antropométricas como TAMT, IMC, CP, CMBM y PCT; para la evaluación de la composición corporal se utilizó bioimpedancia tetrapolar. Se calculo TFG.…”