Background: Early body composition changes, associated with physical inactivity and disease advancement are devastating for patient-related outcomes in predialysis chronic kidney disease (CKD), thus warranting a detailed analysis of body composition beyond conventional measures. Methods: The study included 40 subjects diagnosed with CKD; recruited between January to May 2021. Body composition was measured using the multifrequency analyzer, InBody 770. International Physical Activity Questionnaire-Short Form was used to assess physical activity. Suitable statistical analyses were performed using SPSS 21.0. Results: The mean age of the subjects was 58.68 ± 12.24 years. Sarcopenic obesity was prevalent in 62.5% of the subjects. Body mass index under identified obesity by 15% compared to percent body fat, especially in subjects with low muscle mass. The decline in a unit of estimated glomerular filtration rate (eGFR) significantly correlated with a decrease in weight (p = 0.02), body fat mass (p = 0.05), visceral fat area (p = 0.05), and phase angle (p = 0.01) with marginal changes in waist-hip ratio and extracellular water/total body water. The effect of physical activity on skeletal muscle mass was homogeneous between low and moderate levels, but significantly different from high activity level. Conclusion: Changes in fat and fluid compartment were associated with eGFR decline, whereas higher physical activity positively affected body composition.

Diabetic myonecrosis is an infrequent complication of long-standing, uncontrolled diabetes mellitus. It usually involves the muscles of the lower limbs presenting with acute onset pain and swelling. It is often seen in association with chronic kidney disease. We present a case series of seven episodes seen over 5-year duration. All these patients had a long duration of poorly controlled diabetes associated with other microvascular complications. They were treated conservatively with bed rest, analgesics, vasodilators, and aspirin. The diagnosis is often missed due to its uncommon presentation and a lack of awareness. The disease resolves spontaneously but with poor long-term prognosis.

Neurological involvement in sarcoidosis has varied presentations. Peripheral neuropathy is one of them. Symmetrical axonal type sensory-motor polyneuropathy is the most common form; focal and multifocal neuropathy, polyradiculopathy, and vascular neuropathy are among the others. Cases of demyelinating polyneuropathy masquerading as acute inflammatory demyelinating polyradiculopathy/Guillain–Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy have been reported rarely. Neurosarcoidosis (NS) often masquerades as other disorders, and the occurrence of GBS-like clinical phenotype is a diagnostic challenge. We report a case of NS presenting as atypical GBS.

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