Frailty, multimorbidity and sarcopaenia in haemodialysis patients

Eldehni, Mohamed Tarek

doi:10.1097/mnh.0000000000000834

Cited by 5 publications

(4 citation statements)

References 39 publications

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“…Malnutrition is very common in patients requiring dialysis and leads to sarcopenia in these patients by reducing muscle mass and strength as well as physical performance [ 35 ]. Furthermore, dialysis patients have a lower physical activity compared to healthy people of the same age, which in turn increases muscle wasting [ 36 ]. Malnutrition and lack of physical activity can be important targets for the prevention of sarcopenia and its associated morbidity and mortality in patients with ESRD.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Karakizlis

Trudel

Brose

et al. 2023

Langenbecks Arch Surg

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Purpose The association between sarcopenia of kidney transplant recipients and outcome after kidney transplantation (KT) has not yet been fully understood and is still considered controversial. The aim of our study was to analyze the impact of pre-transplant sarcopenia on graft function, postoperative complication rates, and survival of the patients after renal transplantation. Methods In this retrospective single-center study, all patients who underwent KT (01/2013–12/2017) were included. Demographic data, rejection rates, delayed graft function, and graft and patient survival rates were analyzed. Sarcopenia was measured in computed tomography images by the sex-adjusted Hounsfield unit average calculation (HUAC). Results During the study period, 111 single KTs (38 women and 73 men) were performed. Living donor kidney transplants were performed in 48.6%. In total, 32.4% patients had sarcopenia. Sarcopenic patients were significantly older (59.6 years vs. 49.8 years; p < 0.001), had a higher body mass index (BMI = 27.6 kg/m2 vs. 25.0 kg/m2; p = 0.002), and were more likely to receive deceased donor kidneys (72.2% vs. 41.3%; p = 0.002). Interestingly, 3 years after KT, the creatinine serum levels were significantly higher (2.0 mg/dl vs. 1.5 mg/dl; p = 0.001), whereas eGFR (39.9 ml/min vs. 53.4 ml/min; p = 0.001) and graft survival were significantly lower (p = 0.004) in sarcopenic transplant recipients. Sarcopenic patients stayed in hospital significantly longer postoperatively than those who were non-sarcopenic. Conclusions At the time of kidney transplantation, sarcopenia was found to predict reduced long-term graft function and diminished graft survival after KT. The early identification of sarcopenic patients can not only enable an optimized selection of recipients, but also the initiation of pre-habilitation programs during the waiting period.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Karakizlis

Trudel

Brose

et al. 2023

Langenbecks Arch Surg

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“…On the other hand, acute muscle regeneration is modulated by macrophages, and a greater degree of neutrophilia affects the transition of the appropriate temporal macrophage and is associated with a decrease or even inhibition of regenerative muscle capacity [58,65,66]. Moreover, it is worth mentioning that there is a close relationship between muscle fragility and sarcopenia, as observed in patients with multimorbidity, such as obesity, diabetes mellitus, atherogenic dyslipidemia, and systemic arterial hypertension, in which aging and chronic conditions can lead to extensive oxidative stress, inflammation, and apoptosis [67][68][69].…”

Section: Sarcopenia: Pathophysiological Aspectsmentioning

confidence: 99%

“…Biomedicines 2023, 11, x FOR PEER REVIEW 10 of 29 relationship between muscle fragility and sarcopenia, as observed in patients with multimorbidity, such as obesity, diabetes mellitus, atherogenic dyslipidemia, and systemic arterial hypertension, in which aging and chronic conditions can lead to extensive oxidative stress, inflammation, and apoptosis [67][68][69].…”

Section: Diseases Related To Sarcopeniamentioning

confidence: 99%

Insights into Pathogenesis, Nutritional and Drug Approach in Sarcopenia: A Systematic Review

et al. 2023

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Sarcopenia is a multifactorial condition related to the loss of muscle mass and strength due to aging, eating habits, physical inactivity, or even caused by another disease. Affected individuals have a higher risk of falls and may be associated with heart disease, respiratory diseases, cognitive impairment, and consequently an increased risk of hospitalization, in addition to causing an economic impact due to the high cost of care during the stay in hospitals. The standardization of appropriate treatment for patients with sarcopenia that could help reduce pathology-related morbidity is necessary. For these reasons, this study aimed to perform a systematic review of the role of nutrition and drugs that could ameliorate the health and quality of life of sarcopenic patients and PRISMA guidelines were followed. Lifestyle interventions have shown a profound impact on sarcopenia treatment but using supplements and different drugs can also impact skeletal muscle maintenance. Creatine, leucine, branched-chain amino acids, omega 3, and vitamin D can show benefits. Although with controversial results, medications such as Metformin, GLP-1, losartan, statin, growth hormone, and dipeptidyl peptidase 4 inhibitors have also been considered and can alter the sarcopenic’s metabolic parameters, protect against cardiovascular diseases and outcomes, while protecting muscles.

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“…Maintenance hemodialysis (MHD) is an effective primary therapy for patients with end-stage renal disease (ESRD). However, long-term MHD can result in various complications, including sarcopenia ( Eldehni, 2022 ), which is characterized by the gradual loss of muscle mass and function ( Cruz-Jentoft et al., 2010 ). The prevalence of sarcopenia ranges from 13.2% to 68.0% in patients with MHD ( Dong et al., 2019 ; Matsuzawa et al., 2021 ), which can reduce the lower limb muscle strength of the patients, impair their balance, and increase the risk of adverse outcomes, such as falls ( Hotta et al., 2015 ; Vanden Wyngaert et al., 2022 ), consequently adding a significant disease burden ( Kim et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

The gut microbiota from maintenance hemodialysis patients with sarcopenia influences muscle function in mice

Tang,

Zhang,

Yin

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundSarcopenia is a common complication in patients undergoing maintenance hemodialysis (MHD). Growing evidence suggests a close relationship between the gut microbiota and skeletal muscle. However, research on gut microbiota in patients with sarcopenia undergoing MHD (MS) remains scarce. To bridge this knowledge gap, we aimed to evaluate the pathogenic influence of gut microbiota in the skeletal muscle of patients with MS, to clarify the causal association between gut microbiota and skeletal muscle symptoms in patients with MS and identify the potential mechanisms underlying this causal association.MethodsFecal samples were collected from 10 patients with MS and 10 patients without MS (MNS). Bacteria were extracted from these samples for transplantation. Mice (n=42) were randomly divided into three groups and, after antibiotic treatment, fecal microbiota transplantation (FMT) was performed once a day for 3 weeks. Skeletal muscle and fecal samples from the mice were collected for 16S rRNA gene sequencing and for histological, real-time PCR, and metabolomic analyses.ResultsMice colonized with gut microbiota from MS patients exhibited notable decreases in muscle function and muscle mass, compared with FMT from patients with MNS. Moreover, 16S rRNA sequencing revealed that the colonization of MS gut microbiota reduced the abundance of Akkermansia in the mouse intestines. Metabolome analysis revealed that seven metabolic pathways were notably disrupted in mice transplanted with MS microbiota.ConclusionThis study established a connection between skeletal muscle and the gut microbiota of patients with MS, implying that disruption of the gut microbiota may be a driving factor in the development of skeletal muscle disorders in patients undergoing MHD. This finding lays the foundation for understanding the pathogenesis and potential treatment methods for sarcopenia in patients undergoing MHD.

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Frailty, multimorbidity and sarcopaenia in haemodialysis patients

Cited by 5 publications

References 39 publications

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Insights into Pathogenesis, Nutritional and Drug Approach in Sarcopenia: A Systematic Review

The gut microbiota from maintenance hemodialysis patients with sarcopenia influences muscle function in mice

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