Elevated Creatinine-Based Estimated Glomerular Filtration Rate is Associated with Increased Risk of Sarcopenia, Dysphagia, and Reduced Functional Recovery after Stroke

Yoshimura, Yoshihiro; Wakabayashi, Hidetaka; Nagano, Fumihiko; Bise, Takahiro; Shimazu, Sayuri; Shiraishi, Ai

doi:10.1016/j.jstrokecerebrovasdis.2020.105491

Cited by 12 publications

(8 citation statements)

References 53 publications

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“…Indeed, median age of stroke onset has increased over the past 20 years, and the median age of ischemic stroke onset in women has risen to above the age of 80 years since 2016 [ 8 ]. The high rate of the aging population may have led to an increasing number studies on stroke-related sarcopenia in Japan, which have mostly been conducted in convalescent rehabilitation wards [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Convalescent rehabilitation wards are a unique setting for intensive rehabilitation after the acute phase of stroke [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of sarcopenia in stroke patients in acute hospitals has been reported to be 8.5–33.8% [ 12 , 13 , 14 , 15 , 16 ], and sarcopenia leads to unfavorable outcomes 90 days after stroke [ 15 ]. In post-acute rehabilitation hospitals, approximately 50% of patients suffer from sarcopenia on admission [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], and sarcopenia inhibits functional recovery and return to home in patients with stroke [ 25 ]. In addition, in several studies, pre-stroke sarcopenia was diagnosed using the SARC-F questionnaire [ 33 , 34 , 35 , 36 ], and pre-stroke sarcopenia was a predictor of functional outcome after 3 months [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

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Trajectories of the Prevalence of Sarcopenia in the Pre- and Post-Stroke Periods: A Systematic Review

Inoue

Ueshima

Kawase³

et al. 2022

Nutrients

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Interventions for stroke-related sarcopenia in patients with stroke are needed, but the details of the target population are unclear. This systematic review aimed to identify trajectories of the prevalence of sarcopenia in the pre- and post-stroke periods and to determine the diagnostic criteria used in patients with stroke. We searched for literature in six databases: MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and Ichushi-web (in Japanese). We included 1627 studies in the primary screening, and 35 studies were finally included. Of the 35 studies, 32 (91.4%) included Asian patients, and the criteria of the Asian Working Group for Sarcopenia was mainly used as the diagnostic criteria. Nineteen studies used muscle strength and muscle mass to diagnose sarcopenia, whereas a full assessment, including physical performance, was performed in five studies. The estimated prevalences of sarcopenia in pre-stroke, within 10 days of stroke, and from 10 days to 1 month after stroke were 15.8%, 29.5%, and 51.6%, respectively. Sarcopenia increased by approximately 15% from pre-stroke to 10 days, and increased by approximately 20% from 10 days to 1 month. Healthcare providers should note that the prevalence of sarcopenia increases during the acute phase in patients with stroke.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trajectories of the Prevalence of Sarcopenia in the Pre- and Post-Stroke Periods: A Systematic Review

Inoue

Ueshima

Kawase³

et al. 2022

Nutrients

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“…We conducted a retrospective cohort study at a post-acute care hospital, which included convalescent rehabilitation wards with a total of 135 beds [ 15 ]. The study was conducted between January 2016 and December 2020 and included all stroke patients newly admitted to the wards who were over 70 years old and had a BMI of less than 20.0 kg/m 2 [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Stored Energy Increases Body Weight and Skeletal Muscle Mass in Older, Underweight Patients after Stroke

Yoshimura¹,

Wakabayashi

Momosaki

et al. 2021

Nutrients

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We conducted a retrospective observational study in 170 older, underweight patients after stroke to elucidate whether stored energy was associated with gains in body weight (BW) and skeletal muscle mass (SMM). Energy intake was recorded on admission. The energy requirement was estimated as actual BW (kg) × 30 (kcal/day), and the stored energy was defined as the energy intake minus the energy requirement. Body composition was measured by bioelectrical impedance analysis. The study participants gained an average of 1.0 ± 2.6 kg of BW over a mean hospital stay of 100 ± 42 days with a mean stored energy of 96.2 ± 91.4 kcal per day. They also gained an average of 0.2 ± 1.6 kg of SMM and 0.5 ± 2.3 kg of fat mass (FM). This means about 9600 kcal were needed to gain 1 kg of BW. In addition, a 1 kg increase in body weight resulted in a 23.7% increase in SMM and a 45.8% increase in FM. Multivariate regression analyses showed that the stored energy was significantly associated with gains in BW and SMM. Aggressive nutrition therapy is important for improving nutritional status and function in patients with malnutrition and sarcopenia.

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“…Similarly, Wilkinson et al reported higher levels of cystatin C in sarcopenic patients with CKD than in non‐sarcopenic patients 21 . Yoshimura et al also reported that the use of creatinine‐based eGFR in stroke patients showed an opposite reduction in the prevalence of sarcopenia as kidney function declined 22 . In addition, three previous studies showed that sarcopenia, particularly loss of muscle strength, was associated with increased mortality in patients with CKD 12,17,21 .…”

Section: Kidney Function In Sarcopeniamentioning

confidence: 96%

Kidney function in cachexia and sarcopenia: Facts and numbers

Okamura

Konishi

Butler

et al. 2023

J cachexia sarcopenia muscle

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Cachexia, in the form of unintentional weight loss >5% in 12 months or less, and secondary sarcopenia in the form of muscle wasting are serious conditions that affect clinical outcomes. A chronic disease state such as chronic kidney disease (CKD) often contributes to these wasting disorders. The purpose of this review is to summarize the prevalence of cachexia and sarcopenia, their relationship with kidney function, and indicators for evaluating kidney function in patients with CKD. It is estimated that approximately half of all persons with CKD will develop cachexia with an estimated annual mortality rate of 20%, but few studies have been conducted on cachexia in CKD. Hence, the true prevalence of cachexia in CKD and its effects on kidney function and patient outcomes remain unclear. Some studies have highlighted the concept of protein‐energy wasting (PEW) which usually include sarcopenia and cachexia. Several studies have examined kidney function and CKD progression in patients with sarcopenia. Most studies use serum creatinine levels to estimate kidney function. However, creatinine may be influenced by muscle mass, and creatinine‐based glomerular filtration rate may overestimate kidney function in patients with reduced muscle mass or muscle wasting. Cystatin C, which is least affected by muscle mass, has been used in some studies, and creatinine‐to‐cystatin‐C ratio has emerged as an important prognostic marker. A previous study incorporating 428 320 participants reported that participants with CKD and sarcopenia had a 33% higher hazard of mortality compared with those without (7% to 66%, P = 0.011), and that those with sarcopenia were twice as likely to develop end‐stage kidney disease (hazard ratio: 1.98; 1.45 to 2.70, P < 0.001). Future studies on cachexia and sarcopenia in patients with CKD are needed to report rigorously defined cachexia concerning kidney function. Moreover, in studies on sarcopenia with CKD, it is desirable to accumulate studies using cystatin C to accurately estimate kidney function.

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Elevated Creatinine-Based Estimated Glomerular Filtration Rate is Associated with Increased Risk of Sarcopenia, Dysphagia, and Reduced Functional Recovery after Stroke

Cited by 12 publications

References 53 publications

Trajectories of the Prevalence of Sarcopenia in the Pre- and Post-Stroke Periods: A Systematic Review

Trajectories of the Prevalence of Sarcopenia in the Pre- and Post-Stroke Periods: A Systematic Review

Stored Energy Increases Body Weight and Skeletal Muscle Mass in Older, Underweight Patients after Stroke

Kidney function in cachexia and sarcopenia: Facts and numbers

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