Body composition in chronic kidney disease

Johansen, Kirsten L.; Lee, Carol

doi:10.1097/mnh.0000000000000120

Cited by 60 publications

(59 citation statements)

References 66 publications

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“…Evidence outside the oncology setting shows that low SMI is present in multiple disease states, including diabetes, COPD, arthritis, PVD, CHF, advanced renal disease, and cirrhosis. [27][28][29][30][31][32][33] Reduced SMD has been reported in elderly individuals and individuals with diverse types of diseases, such as diabetes, obesity, and cirrhosis. [34][35][36] The pathogenesis of low SMI and low SMD in chronic diseases is not completely understood.…”

Section: Discussionmentioning

confidence: 99%

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Xiao

Caan

Weltzien

et al. 2018

J cachexia sarcopenia muscle

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Background and aimCo‐morbidities and computerized tomography‐measured muscle abnormalities are both common in cancer patients and independently adversely influence clinical outcomes. Muscle abnormalities are also evident in other diseases, such as diabetes and obesity. This study examined for the first time the association between co‐morbidities and muscle abnormalities in patients diagnosed with colorectal cancer (CRC).MethodsThis cross‐sectional study included 3051 non‐metastatic patients with Stages I–III CRC. Muscle abnormalities, measured at diagnosis, were defined as low skeletal muscle mass index (SMI) or low skeletal muscle radiodensity (SMD) quantified using computerized tomography images using optimal stratification. Co‐morbidities included in the Charlson index were ascertained. χ2 tests were used to compare the prevalence of co‐morbidities by the presence or absence of each muscle abnormality. Logistic regressions were performed to evaluate which co‐morbidities predicted muscle abnormalities adjusting for age, sex, body mass index, weight change, cancer stage, cancer site, race/ethnicity, and smoking.ResultsMean age was 63 years; 50% of patients were male. The prevalence of low SMI and low SMD were 43.1% and 30.2%, respectively. Co‐morbidities examined were more prevalent in patients with low SMD than in those with normal SMD, and most remained independent predictors of low SMD after adjustment for covariates. Co‐morbidities associated with higher odds of low SMD included myocardial infarction [odds ratio (OR) = 1.77, P = 0.023], congestive heart failure (OR = 3.27, P < 0.001), peripheral vascular disease (OR = 2.15, P = 0.002), diabetes with or without complications (OR = 1.61, P = 0.008; OR = 1.46, P = 0.003, respectively), and renal disease (OR = 2.21, P < 0.001). By contrast, only diabetes with complications was associated with lower odds of low SMI (OR = 0.64, P = 0.007).ConclusionsPrevalence of muscle abnormalities was high in patients with non‐metastatic CRC. Pre‐existing co‐morbidities were associated with low SMD, suggestive of a potential shared mechanism between fat infiltration into muscle and each of these co‐morbidities.

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Section: Discussionmentioning

confidence: 99%

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Xiao

Caan

Weltzien

et al. 2018

J cachexia sarcopenia muscle

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“…The superiority of survival advantages of (gaining) muscle compared to fat mass was confirmed by calculating the relation of lean to fat mass index which results in more favorable outcomes in patients with advanced CKD stages with a high lean/fat tissue index [24]. New insights of the meaning of muscle mass compared to fat mass in body weight gain comes from the "sarcopenia obesity" concept [25]. Increasing BMI in dialysis patients does not exclude concurrent muscle wasting.…”

Section: Obesity In Advanced Ckd and Dialysis: A Paradoxmentioning

confidence: 99%

Preventive Nephrology: The Role of Obesity in Different Stages of Chronic Kidney Disease

Pommer¹

2018

Kidney Dis

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Background: Obesity is increasing worldwide and has become a nontraditional risk factor in chronic kidney disease (CKD). Summary: Obesity-related nephropathy may aggravate renal complications of the metabolic syndrome and progress to advanced CKD stages, while obesity in early stages of CKD is clearly related to the development of kidney disease. A high body mass index (BMI) in advanced CKD stages and dialysis is an advantage for survival (so called “obesity paradox”). A high lean body to fat mass index indicates a beneficial state of body composition. In contrast, loss of muscle mass with increasing fat mass causes “sarcopenia obesity,” which is related to unfavorable outcomes in renal replacement therapy. Obesity (BMI > 30–35) in renal transplant recipients is associated with a higher risk of complications such as delayed graft function, increased rates of rejection, and graft loss. While conservative management of morbid obesity is failing in most cases, bariatric surgery seems to be an option in some cases to improve renal complications in the early stage of CKD or in transplant candidates. Key Message: In conclusion, obesity is increasingly prevalent among CKD patients. Adequate management with respect to the specific role of obesity in different stages of CKD should be integrated in routine renal care.

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“…Despite the high prevalence of obesity among ESRD patients, protein energy wasting or muscle wasting is not uncommon [78]. The increasing BMI in the dialysis population does not exclude concurrent muscle wasting.…”

Section: Magnitude Of Low Muscle Mass and Sarcopenia With Associated mentioning

confidence: 99%

Body Composition and Its Clinical Outcome in Maintenance Hemodialysis Patients

Kittiskulnam¹,

Eiam‐Ong²

2018

Aspects in Dialysis

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Previous epidemiological cohorts demonstrated that higher body mass index (BMI) was associated with greater survival in patients treated by hemodialysis. Although BMI is a simple measure of adiposity in general population, it may be an inaccurate indicator of nutritional status, particularly among dialysis patients given that it does not differentiate between muscle mass and fat as well as body fat distribution. This problem might be aggravated in end-stage renal disease patients because of wasting or edema. In addition, individuals with higher BMI usually have both higher muscle and fat mass than those with lower BMI. Therefore, more sophisticated tool of body composition analysis is needed to address the query of which component is associated with mortality outcome among patients receiving hemodialysis. We summarized the current state of body composition, including lean and fat tissue evaluated by bioelectrical impedance analysis, dual X-ray absorptiometry, computerized tomography, or magnetic resonance imaging, and its association with clinical outcomes among hemodialysis patients. The studies using anthropometry for the estimation of muscle mass, either mid-arm muscle circumference as a proxy of muscle mass or skinfold thickness and waist circumference as a surrogate of body fat and visceral fat, respectively, were all included in this review.

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Body composition in chronic kidney disease

Cited by 60 publications

References 66 publications

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Associations of pre‐existing co‐morbidities with skeletal muscle mass and radiodensity in patients with non‐metastatic colorectal cancer

Preventive Nephrology: The Role of Obesity in Different Stages of Chronic Kidney Disease

Body Composition and Its Clinical Outcome in Maintenance Hemodialysis Patients

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