Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease

Kim, Jwa-Kyung; Choi, Sun Ryoung; Choi, Myung Jin; Kim, Sung Gyun; Lee, Young Ki; Noh, Jung Woo; Kim, Hyung Jik; Song, Young Rim

doi:10.1016/j.clnu.2013.04.002

Cited by 235 publications

(210 citation statements)

References 25 publications

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“…In our study, sarcopenia was present in 20% of incident dialysis patients. This prevalence is in line with a previous report in CKD stage$3 (16) and prevalent hemodialysis patients (17). It has been proposed that advanced CKD is a condition associated with a process of "accelerated aging" (11,12) and that the effect of various prevalent CKD-associated catabolic alterations may explain why sarcopenia is such a prominent typical feature in CKD (14).…”

Section: Discussionsupporting

confidence: 79%

“…Although the term sarcopenia is often used in the literature to describe muscle derangements in patients with CKD (13)(14)(15), there are only two studies that have formally assessed its prevalence and clinical correlates. Sarcopenia was more prevalent in individuals with CKD stage$3 than in individuals with normal renal function (16), whereas it affected one third of prevalent hemodialysis patients (17).…”

Section: Introductionmentioning

confidence: 99%

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Comparative Associations of Muscle Mass and Muscle Strength with Mortality in Dialysis Patients

Isoyama

Qureshi

Avesani³

et al. 2014

Clinical Journal of the American Society of Nephrology

436

353

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Background and objectives Reduced muscle mass and strength are prevalent conditions in dialysis patients. However, muscle strength and muscle mass are not congruent; muscle strength can diminish even though muscle mass is maintained or increased. This study addresses phenotype and mortality associations of these muscle dysfunction entities alone or in combination (i.e., concurrent loss of muscle mass and strength/mobility, here defined as sarcopenia).Design, setting, participants, & measurements This study included 330 incident dialysis patients (203 men, mean age 53613 years, and mean GFR 762 ml/min per 1.73 m 2 ) recruited between 1994 and 2010 and followed prospectively for up to 5 years. Low muscle mass (by dual-energy x-ray absorptiometry appendicular mass index) and low muscle strength (by handgrip) were defined against young reference populations according to the European Working Group on Sarcopenia in Older People.Results Whereas 20% of patients had sarcopenia, low muscle mass and low muscle strength alone were observed in a further 24% and 15% of patients, respectively. Old age, comorbidities, protein-energy wasting, physical inactivity, low albumin, and inflammation associated with low muscle strength, but not with low muscle mass (multivariate ANOVA interactions). During follow-up, 95 patients (29%) died and both conditions associated with mortality as separate entities. When combined, individuals with low muscle mass alone were not at increased risk of mortality (adjusted hazard ratio [HR], 1.23; 95% confidence interval [95% CI], 0.56 to 2.67). Individuals with low muscle strength were at increased risk, irrespective of their muscle stores being appropriate (HR, 1.98; 95% CI, 1.01 to 3.87) or low (HR, 1.93; 95% CI, 1.01 to 3.71).Conclusions Low muscle strength was more strongly associated with aging, protein-energy wasting, physical inactivity, inflammation, and mortality than low muscle mass. Assessment of muscle functionality may provide additional diagnostic and prognostic information to muscle-mass evaluation.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Comparative Associations of Muscle Mass and Muscle Strength with Mortality in Dialysis Patients

Isoyama

Qureshi

Avesani³

et al. 2014

Clinical Journal of the American Society of Nephrology

436

353

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“…On the contrary, serum IL6 levels did not differ between people with sarcopenia (n=1113) versus those with sarcopenia (n=1981) (7 studies [22], [26], [29], [30], [33]- [35]; SMD=0.35; 95%CI: -0.19, 0.89; p=0.21; I 2 =97%) (Figure 2). Similarly, people with sarcopenia (n=1031) had similar levels of TNFcompared to those without sarcopenia (n=1767) (5 studies [22], [26], [29], [33], [35] ; SMD=0.28; 95%CI: -0.26, 0.83; p=0.31; I 2 =97%) (Figure 3).…”

Section: Cross-sectional Studies Reporting On Serum Crp Il6 and Tnf-mentioning

confidence: 99%

Inflammation and sarcopenia: A systematic review and meta-analysis

et al. 2017

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Nicola.Inflammation and sarcopenia: A systematic review and meta-analysis.Maturitas http://dx.doi.org/10.1016/j.maturitas. 2016.11.006 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights Sarcopenia is associated with functional impairment and adverse outcomes.  Highly inflammatory cytokines are negatively related to muscle strength and mass.  Sarcopenia is associated with higher serum inflammatory parameters.  Chronic inflammation could play a role in sarcopenia. AbstractInflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. However, the possible association between inflammatory parameters and sarcopenia is poorly understood. We therefore aimed to summarize the current evidence about this topic with a meta-analysis of studies reporting serum inflammatory parameters in patients with sarcopenia vs. people without sarcopenia (controls). An electronic PubMed and Scopus search through to 09/01/2016 and meta-analysis of cross-sectional studies comparing serum levels of inflammatory cytokines between patients with sarcopenia and controls was made, calculating random-effects standardized mean differences (SMDs) ±95% confidence intervals (CIs) as the effect size. Out of 1370 initial hits, 17 studies with a total of 11249 participants (3072 with sarcopenia and 8177 without) were meta-analysed. Sarcopenic participants had significantly higher levels of CRP (SMD=0.51; 95%CI 0.26, 0.77; p<0.0001; I 2 =96%) than controls. Conversely, serum IL6 levels were not significantly different (SMD=0.35; 95%CI: -0.19, 0.89; p=0.21; I 2 =97%) in people with sarcopenia versus controls. Sarcopenic people did not have higher levels of TNF-than controls (SMD=0.28; 95%CI -0.26, 0.83; p=0.31; I 2 =97%). In conclusion, sarcopenia seems to be associated with elevated serum CRP levels; future longitudinal studies are needed to clarify this relationship.

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“…For example, 40 % of the older emergency medical admissions (mean age 83 years) were identified as frail according to the Cardiovascular Health Study phenotype definition in a Belgium study (85) and a recent prospective study in the UK identified 28 % of older patients (mean age 77 years) attending three acute surgical admission units as frail (86) . In the outpatient setting, 26 % of urology, surgical oncology and general surgery patients in the USA (mean age 62 years) were deemed frail or pre-frail (87) and 37·0 % of men and 29·3 % of women (mean age 64 years) attending a dialysis unit in Korea had sarcopenia (defined as low muscle mass and strength) (88) . Presently many studies of prevalence in the clinical setting do not use internationally recognised definitions to identify cases and some caution must be used when comparing the results between clinical and epidemiological studies.…”

Section: Sarcopenia and Frailty In Clinical Practicementioning

confidence: 99%

Ageing well: a review of sarcopenia and frailty

2015

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Conference on 'Nutrition and age-related muscle loss, sarcopenia and cachexia' 'Ageing well' has been declared a global health priority by the World Health Organisation and the role of sarcopenia and frailty in late-life health is receiving increasing attention. Frailty is the decline in an individual's homeostatic function, strength and physiologic reserves leading to increased vulnerability, while sarcopenia describes the loss of muscle mass and function with age. The conceptual definitions of these conditions have been widely agreed but there is a lack of consensus on how to measure them. We review the different operational definitions described in the literature and the evidence that, whatever definition used, the prevalence and clinical impact of these conditions is high. We also consider the commonality of low physical function to both conditions, a feature which could provide a pragmatic way forward in terms of identifying those at risk. Objective measures of physical function such as usual walking speed are simple and feasible measures, extensively validated against health outcomes. Additionally, clinical applications of sarcopenia and frailty are reviewed with particular consideration to their potential role in the management of older people undergoing surgery. Frailty appears to outperform traditional anaesthetic and surgical risk scores in terms of its association with post-operative complications, length of hospital stay, institutionalisation and mortality. However, even within this sub-specialty area there is wide variation in the approaches used to measure frailty and there is an urgent need for studies to utilise established, validated and reproducible methods to identify sarcopenia and frailty in their study participants, in order to expedite scientific development. Sarcopenia: Frail elderly: AgeingBy 2050 the proportion of the world's population aged ⩾60 years is projected to be 22 %, double the proportion recorded at the turn of the new millennium (1) . Although population ageing is in one way a great public health success story, with mortality rates among older people continuing to fall (2) , in another way it presents significant challenges. For example, in the UK 60 % of people admitted to hospital are ⩾65 years old despite this age-group only comprising 17 % of the total UK population (3) . This disproportionate use of healthcare services by older people not only demonstrates the significant economic implications of an ageing population (4) , but also the morbidity experienced by many older people, reducing quality of life. However, it is not inevitable that *Corresponding author: Dr V. L. Keevil, fax +44 (0)1223 748676, email vlk20@cam.ac.uk Abbreviations: CGA, comprehensive geriatric assessment; FI, frailty index; PFP, physical frailty phenotype.

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Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease

Cited by 235 publications

References 25 publications

Comparative Associations of Muscle Mass and Muscle Strength with Mortality in Dialysis Patients

Comparative Associations of Muscle Mass and Muscle Strength with Mortality in Dialysis Patients

Inflammation and sarcopenia: A systematic review and meta-analysis

Ageing well: a review of sarcopenia and frailty

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