Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment

Silva, Maria Inês Barreto; Picard, Kelly; Klein, Márcia Regina Simas Torres

doi:10.1097/mco.0000000000000871

Cited by 23 publications

(14 citation statements)

References 69 publications

(173 reference statements)

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“…A reduction in muscle mass together with increased body fat could be the expression of sarcopenic obesity [ 33 ], which represents a strong marker for a worse clinical prognosis in general populations [ 34 ]. In the present study, we confirm that a marker of adiposity and reduced somatic muscle mass such as FM%/MAMC is also a good predictor of mortality in CKD patients.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis, Prevalence and Significance of Obesity in a Cohort of CKD Patients

et al. 2023

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Background: data regarding the association between obesity and morbidity/mortality in patients with chronic kidney disease (CKD) are uncertain and sometimes contradictory. The aims of our study were to determine the associations among different measures of obesity and adiposity, and the risk of all-cause mortality or dialysis entry in stage 3–5 CKD patients. Materials: this observational cohort study included 178 CKD patients followed for a median of 71 months. Biochemistry, anthropometric measures such as body mass index (BMI), waist-to-hip ratio, mid-arm muscle circumference (MAMC) and body composition by bioimpedance analysis were evaluated. Results: we found a weak agreement between BMI and other measures of adiposity. In multivariable regression analysis, all measures of obesity such as BMI, waist circumference and waist-to-height ratio were not associated with dialysis entry and/or mortality. Instead, MAMC was associated with dialysis entry HR 0.82 [95%, CI: 0.75–0.89] and high FM% with mortality HR 2.08 [95%, CI: 1.04–4.18]. Conclusions: in our CKD population, lower MAMC was predictive of dialysis commencing, while a higher percentage of fatty mass was a predictor of mortality. Instead, obesity, as defined by BMI, is not associated with dialysis commencing or all-cause mortality.

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Section: Discussionmentioning

confidence: 99%

Diagnosis, Prevalence and Significance of Obesity in a Cohort of CKD Patients

et al. 2023

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“…Sarcopenia is prevalent in the CKD population and is characterized by a loss of muscle mass and function ( 44 ). Sarcopenia is considered a significant complication in dialysis-dependent CKD patients, along with frailty ( 45 ), which is defined as a multisystem impairment associated with increased vulnerability to stress ( 46 ).…”

Section: Sarcopeniamentioning

confidence: 99%

The “adult inactivity triad” in patients with chronic kidney disease: A review

2023

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BackgroundThe “pediatric inactivity triad” framework consists of three complex, interrelated conditions influencing physical inactivity and associated health risks. Evidence on the beneficial effects of physical activity in adults with chronic kidney disease (CKD) continues to grow, but few studies have explored the complex interactions behind inactivity in this population.ResultsBased on the “pediatric inactivity triad” framework and prior research, we would like to propose a new concept, the “adult inactivity triad” in CKD, including (1) exercise deficit disorder, (2) sarcopenia, and (3) physical illiteracy. Individuals can shift from “adult inactivity triad” to “adult activity triad” and move at different rates and directions along the arrows in each of the three components.ConclusionThis review explores and summarizes previous research on the three main adult inactivity triad components in the chronic kidney disease population.

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“…25 It is important to note that body fat, skeletal muscle mass and visceral protein content may be differentially affected by pathological processes, 26 and the phenomenon of 'sarcopenic obesity' is increasingly being recognized. 27 Accumulating evidence suggests that skeletal muscle mass is the principal component that governs clinical outcome. 28,29 Notably, although frail patients have low muscle mass, they also tend to be obese.…”

Section: From Sarcopenia To Frailtymentioning

confidence: 99%

From MIA to FIFA: The vicious matrix of frailty, inflammation, fluid overload and atherosclerosis in peritoneal dialysis

Chan¹,

Fung²,

Szeto

et al. 2023

Nephrology

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Cardiovascular disease (CVD) is a major cause of mortality and morbidity in peritoneal dialysis (PD) patients. Two decades ago, the common co-existence of malnutrition and systemic inflammation PD patients with atherosclerosis and CVD led to the proposed terminology of 'malnutrition-inflammation-atherosclerosis (MIA) syndrome'. Although the importance of malnutrition is well accepted, frailty represents a more comprehensive assessment of the physical and functional capability of the patient and encompasses the contributions of sarcopenia (a key component of malnutrition), obesity, cardiopulmonary as well as neuropsychiatric impairment.In recent years, it is also increasingly recognized that fluid overload is not only the consequence but also play an important role in the pathogenesis of CVD. Moreover, fluid overload is closely linked with the systemic inflammatory status, presumably by gut oedema, gastrointestinal epithelial barrier dysfunction and leakage of bacterial fragments to the systemic circulation. There are now a wealth of published evidence to show intricate relations between frailty, inflammation, fluid overload and atherosclerotic disease in patients with chronic kidney disease (CKD) and those on PD, a phenomenon that we propose the term 'FIFA complex'. In this system, frailty and atherosclerotic disease may be regarded as two patientoriented outcomes, while inflammation and fluid overload are two inter-connected pathogenic processes. However, there remain limited data on how the treatment of one component affect the others. It is also important to define how treatment of fluid overload affect the systemic inflammatory status and to develop effective anti-inflammatory strategies that could alleviate atherosclerotic disease and frailty.

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Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment

Cited by 23 publications

References 69 publications

Diagnosis, Prevalence and Significance of Obesity in a Cohort of CKD Patients

Diagnosis, Prevalence and Significance of Obesity in a Cohort of CKD Patients

The “adult inactivity triad” in patients with chronic kidney disease: A review

From MIA to FIFA: The vicious matrix of frailty, inflammation, fluid overload and atherosclerosis in peritoneal dialysis

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