Identification of sarcopenia and dynapenia in CKD predialysis patients with EGWSOP2 criteria: An observational, cross-sectional study

Guida, Bruna; Maro, Martina Di; Lauro, Mariastella Di; Lauro, Teresa Di; Trio, Rossella; Santillo, Mariarosaria; Belfiore, A.; Memoli, Andrea; Cataldi, Mauro

doi:10.1016/j.nut.2020.110815

Cited by 18 publications

(14 citation statements)

References 28 publications

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“…Low albumin is often used as a biochemical marker of malnutrition and poor nutritional status, which may result in protein synthesis degradation and muscle weakness 52 . We observed that sarcopenic participants had lower serum albumin, supporting previous research in older adults 52 and in patients with CKD, 21 although absolute differences in albumin between sarcopenic and non‐sarcopenia patients were small. We saw no association between with sarcopenia and the weekly meat intake (a crude surrogate for increased dietary protein), although detailed investigation of macronutrients may provide a better understanding of the role of diet in sarcopenia.…”

Section: Discussionsupporting

confidence: 87%

“…found probable sarcopenia was evident in 63% of patients, with confirmed sarcopenia in 24%. Guida et al 21 . found the prevalence of sarcopenia and dynapenia (low HGS) was, respectively, 7.1% and 17.6% in 85 patients.…”

Section: Discussionmentioning

confidence: 98%

“…This is likely due to a lack of sarcopenia recognition and assessment in UK healthcare organizations 8 . In studies of non‐dialysis CKD, sarcopenia prevalence estimates range widely from 6% to 19% 12,13,15,20,21,34,35 . However, the ability to compare studies is greatly limited by the diverse definitions employed.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of sarcopenia in non‐dialysis CKD patients are limited by low sample sizes, lack of control group, and inconsistent use of definitions 12,21–23 The aims of this study were to (i) identify the prevalence of sarcopenia in a large cohort of individuals with CKD; (ii) identify the risk factors of sarcopenia in those with CKD; and (iii) explore the association of sarcopenia with all‐cause mortality and progression to ESRD.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with end‐stage renal disease (ESRD) and on dialysis, sarcopenia has a prevalence of between 20% and 55% 14–18 and is associated with an increased mortality risk 13,14,16,18,19 . However, the prevalence in earlier non‐dialysis CKD stages is less well‐defined, and the association with unfavourable outcomes is poorly understood 9,12,20,21 . Given that sarcopenia characteristics (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Wilkinson

Miksza

Yates

et al. 2021

J cachexia sarcopenia muscle

115

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Background Sarcopenia, a degenerative and generalized skeletal muscle disorder involving the loss of muscle function and mass, is an under‐recognized problem in clinical practice, particularly in chronic kidney disease (CKD). We aimed to investigate the prevalence of sarcopenia in individuals with CKD, its risk factors, and its association with all‐cause mortality and progression to end‐stage renal disease (ESRD). Methods UK Biobank participants were grouped according to the presence of CKD (defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2) and as having probable (low handgrip strength), confirmed (plus low muscle mass), and severe sarcopenia (plus poor physical performance) based on the 2019 European Working Group of Sarcopenia in Older People and Foundation for the National Institutes of Health criteria. Risk factors were explored using logistic regression analysis. Survival models were applied to estimate risk of mortality and ESRD. Results A total of 428 320 participants, of which 8767 individuals with CKD (46% male, aged 62.8 (standard deviation 6.8) years, median estimated glomerular filtration rate 54.5 (interquartile range 49.0–57.7) mL/min/1.72 m2) were included. Probable sarcopenia was present in 9.7% of individuals with CKD compared with 5.0% in those without (P < 0.001). Sarcopenia was associated with being older; inflammation; poorer renal function; and lower serum albumin, total testosterone, and haemoglobin. The largest risk factors for sarcopenia were having three or more comorbidities (odds ratio: 2.30; 95% confidence interval: 1.62 to 3.29; P < 0.001) and physical inactivity: participants in the highest quartile of weekly activity were 43% less likely to have sarcopenia compared to the lowest quartile (odds ratio: 0.57; 0.42 to 0.76; P < 0.001). Participants with CKD and sarcopenia had a 33% (7% to 66%; P = 0.011) higher hazard of mortality compared with individuals without. Sarcopenic CKD individuals had a 10 year survival probability of 0.85 (0.82 to 0.88) compared with 0.89 (0.88 to 0.30) in those without sarcopenia, an absolute difference of 4%. Those with sarcopenia were twice as likely to develop ESRD (hazard ratio: 1.98; 1.45 to 2.70; P < 0.001). Conclusions Participants with reduced kidney function are at an increased risk of premature mortality. The presence of sarcopenia increases the risk of mortality and ESRD. Appropriate measurement of sarcopenia should be used to identify at‐risk individuals. Interventions such as physical activity should be encouraged to mitigate sarcopenia.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Wilkinson

Miksza

Yates

et al. 2021

J cachexia sarcopenia muscle

115

View full text Add to dashboard Cite

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Male Sex and Ageing are Independent Risk Factors for Sarcopenia Stage in Patients With Chronic Kidney Disease Not Yet on Dialysis

Huang,

Liu,

Muo

et al. 2024

J cachexia sarcopenia muscle

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BackgroundThe risk of sarcopenia in older adults with chronic kidney disease (CKD) not yet on dialysis is controversial. The aims of this study were to investigate the association among sarcopenia, diabetes and predialysis CKD and evaluate the impact of gender and ageing on the risk of sarcopenia statuses in older patients with predialysis CKD.MethodsThe participants aged ≥60 years old were recruited from the community of New Taipei City, Taiwan. Handgrip strength, appendicular skeletal muscle mass and the 6‐m walk were measured. The diagnosis of sarcopenia was established based on the consensus of Asian Sarcopenia Working Group 2019. These older adults were categorised into G1, G2 and G3–5 according to the guidelines of Kidney Disease Improving Global Outcomes (KDIGO) after calculating the estimated glomerular filtration rate by the Modification of Diet in Renal Disease equation. The Chi‐square test and ANOVA were used to estimate the difference of categorical and continuous variables, respectively. Polytomous logistic regression was employed to assess the odds ratio (OR) and 95% confidence intervals (CIs) of the sarcopenia status and sarcopenia‐associated risk factors in the predialysis CKD patients. All tests were two‐sided, and p < 0.05 was defined as statistical significance.ResultsAmong the 3648 older adults (mean age: 71.9 ± 6.07 years), including 1701 males and 1947 females, 870 (23.9%), 94 (2.58%) and 48 (1.32%) had possible sarcopenia, sarcopenia and severe sarcopenia, respectively. After adjustment, the risk for possible sarcopenia, sarcopenia and severe sarcopenia significantly increased with ageing (OR = 1.11, 1.10 and 1.23; 95% CI = 1.10–1.13, 1.07–1.15 and 1.18–1.30, respectively) and male gender (OR = 2.26, 20.3 and 25.4; 95% CI = 1.87–2.73, 11.5–36.0 and 11.3–57.2, respectively). Compared with KDIGO G1, no significant association between KDIGO G3–5 and the statuses of sarcopenia was observed (OR = 0.97, 0.88 and 0.91; 95% CI = 0.75–1.26, 0.43–1.78 and 0.37–2.27, p = 0.821, 0.718, 0.838, for possible sarcopenia, sarcopenia and severe sarcopenia, respectively). Ageing and male gender indicated a significant risk for higher sarcopenia status in older patients with predialysis CKD (0.027‐fold/year and 0.284‐fold, respectively) (p < 0.0001).ConclusionsThis study illuminated the importance of the male sex and the ageing process on the risk of sarcopenia progression in patients with predialysis CKD. Early clinical screening and aggressive treatment for the prevention of higher sarcopenia status in advanced older male adults with predialysis CKD are recommended.

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Frailty in kidney transplant candidates: a comparison between physical frailty phenotype and FRAIL scales

et al. 2022

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Identification of sarcopenia and dynapenia in CKD predialysis patients with EGWSOP2 criteria: An observational, cross-sectional study

Cited by 18 publications

References 28 publications

Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Association of sarcopenia with mortality and end‐stage renal disease in those with chronic kidney disease: a UK Biobank study

Male Sex and Ageing are Independent Risk Factors for Sarcopenia Stage in Patients With Chronic Kidney Disease Not Yet on Dialysis

Frailty in kidney transplant candidates: a comparison between physical frailty phenotype and FRAIL scales

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