The clinical applicability of ultrasound technique for diagnosis of sarcopenia in hemodialysis patients

Matsuzawa, Ryota; Yamamoto, Shohei; Suzuki, Yuta; Imamura, Keigo; Harada, Manae; Matsunaga, Atsuhiko; Tamaki, Akira; Fukui, Takayuki; Shimokado, Kiyoshi

doi:10.1016/j.clnu.2020.07.025

Cited by 29 publications

(34 citation statements)

References 26 publications

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“…However, this merged result was lacking robustness caused by the high heterogeneity and small sample size of some studies among the included literature. For example, in two included articles that both diagnosed sarcopenia by combined criteria (LMM plus LMS and/or LPP), one reported the prevalence of sarcopenia in dialysis as 4%, 13 while the value in the other was 68%, 14 and both only involved 50 cases. The random‐effects model was applied in response to the high heterogeneity between the studies; however, the differences between the two groups became statistically significant when we implemented the fixed‐effects model, and this further proved that the merged result was not satisfactorily robust and the conclusion lacked reliability.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta‐analysis

Shu

Lin

Wang

et al. 2022

J cachexia sarcopenia muscle

121

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There is no consensus on the prevalence of sarcopenia or its impact on mortality in end-stage renal disease patients undergoing dialysis. This review aimed to summarize the diagnostic criteria of sarcopenia and its prevalence and impact on the mortality of end-stage renal disease patients undergoing dialysis. Embase, MEDLINE, PubMed, and Cochrane Library were searched from inception to 8 May 2021 to retrieve eligible studies that assessed muscle mass by commonly used instruments, such as dual-energy X-ray absorptiometry, bioelectrical impedance analysis, magnetic resonance imaging, and body composition monitor. Two assessment tools matched to study designs were employed to evaluate study quality. Pooled sarcopenia prevalence was calculated with 95% confidence interval (CI), and heterogeneity was estimated using the I 2 test. Associations of sarcopenia with mortality were expressed as hazard ratio (HR) and 95% CI. The search identified 3272 studies, and 30 studies (6162 participants, mean age from 47.5 to 77.5 years) were analysed in this review. The risk of bias in the included studies was low to moderate. Twenty-two studies defined sarcopenia based on low muscle mass (LMM) plus low muscle strength and/or low physical performance, while eight studies used LMM alone. Muscle mass was assessed by different instruments, and a wide range of cut-off points were used to define LMM. Overall, sarcopenia prevalence was 28.5% (95% CI 22.9-34.1%) and varied from 25.9% (I 2 = 94.9%, 95% CI 20.4-31.3%; combined criteria) to 34.6% (I 2 = 98.1%, 95% CI 20.9-48.2%; LMM alone) (P = 0.247 between subgroups). The statistically significant differences were not found in the subgroups of diagnostic criteria (P > 0.05) and dialysis modality (P > 0.05). Additionally, the sarcopenia prevalence could not be affected by average age [regression coefficient 0.004 (95% CI: À0.005 to 0.012), P = 0.406] and dialysis duration [regression coefficient 0.002 (95% CI À0.002 to 0.005), P = 0.327] in the meta-regression. The pooled analyses showed that combined criteria of sarcopenia were related to a higher mortality risk [HR 1.82 (I 2 = 26.3%, 95% CI 1.38-2.39)], as was LMM [HR 1.61 (I 2 = 26.0%, 95% CI 1.31-1.99)] and low muscle strength [HR 2.04 (I 2 = 80.4%, 95% CI 1.19-3.5)]. Although there are substantial differences in diagnostic criteria, sarcopenia is highly prevalent in dialysis patients and is linked to increased mortality. The standardization of sarcopenia diagnostic criteria would be beneficial, and future longitudinal studies are needed to investigate the prevalence and prognostic value of sarcopenia in dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta‐analysis

Shu

Lin

Wang

et al. 2022

J cachexia sarcopenia muscle

121

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“…The studies included in this review were all published in 2020 or 2021. The study populations were elderly people ( > 60 years) [ 11 , 12 ] or patients with varying diseases [13][14][15][16] . The mean age of the participants in the studies ranged from 52 to 79 [11][12][13][14][15][16] .…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The study populations were elderly people ( > 60 years) [ 11 , 12 ] or patients with varying diseases [13][14][15][16] . The mean age of the participants in the studies ranged from 52 to 79 [11][12][13][14][15][16] . Different types of ultrasound systems were used, and the transducer frequencies ranged from 4-12 MHz.…”

Section: Study Characteristicsmentioning

confidence: 99%

The Diagnostic Value of Ultrasound of the Rectus Femoris for the diagnosis of Sarcopenia in adults: A systematic review

Nies

Ackermans

Poeze

et al. 2022

Injury

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“…Although some criteria have been developed to define sarcopenia, 4 the feasibility of using such criteria in CKD patients has not yet been clarified yet 23 . The type of test used to detect sarcopenia may influence the diagnosis of sarcopenia in CKD patients 24 . For example, the hypervolaemia seen in CKD patients may act on the bioelectrical impedance analysis; but the measurement of the lean mass by dual‐energy X‐ray absorptiometry is not influenced 25 …”

Section: Introductionmentioning

confidence: 99%

“… 23 The type of test used to detect sarcopenia may influence the diagnosis of sarcopenia in CKD patients. 24 For example, the hypervolaemia seen in CKD patients may act on the bioelectrical impedance analysis; but the measurement of the lean mass by dual‐energy X‐ray absorptiometry is not influenced. 25 …”

Section: Introductionmentioning

confidence: 99%

Effects of hormonal changes on sarcopenia in chronic kidney disease: where are we now and what can we do?

Güngör

Ulu

Hasbal

et al. 2021

J cachexia sarcopenia muscle

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Sarcopenia or muscle wasting is a progressive and generalized skeletal muscle disorder involving the accelerated loss of muscle mass and function, often associated with muscle weakness (dynapenia) and frailty. Whereas primary sarcopenia is related to ageing, secondary sarcopenia happens independent of age in the context of chronic disease states such as chronic kidney disease (CKD). Sarcopenia has become a major focus of research and public policy debate due to its impact on patient's health‐related quality of life, health‐care expenditure, morbidity, and mortality. The development of sarcopenia in patients with CKD is multifactorial and it may occur independently of weight loss or cachexia including under obese sarcopenia. Hormonal imbalances can facilitate the development of sarcopenia in the general population and is a common finding in CKD. Hormones that may influence the development of sarcopenia are testosterone, growth hormone, insulin, thyroid hormones, and vitamin D. Although the relationship between free testosterone level that is low in uraemic patients and sarcopenia in CKD is not well‐defined, functional improvement may be seen. Unlike testosterone, it is known that vitamin D is associated with muscle strength, muscle size, and physical performance in patients with CKD. Outcomes after vitamin D replacement therapy are still controversial. The half‐life of growth hormone (GH) is prolonged in patients with CKD. Besides, IGF‐1 levels are normal in patients with Stage 4 CKD—a minimal reduction is seen in the end‐stage renal disease. Unresponsiveness or resistance of IGF‐1 and changes in the GH/IGF‐1 axis are the main causes of sarcopenia in CKD. Low serum T3 level is frequent in CKD, but the net effect on sarcopenia is not well‐studied. CKD patients develop insulin resistance (IR) from the earliest period even before GFR decline begins. IR reduces glucose utilization as an energy source by hepatic gluconeogenesis, decreasing muscle glucose uptake, impairing intracellular glucose metabolism. This cascade results in muscle protein breakdown. IR and sarcopenia might also be a new pathway for targeting. Ghrelin, oestrogen, cortisol, and dehydroepiandrosterone may be other players in the setting of sarcopenia. In this review, we mainly examine the effects of hormonal changes on the occurrence of sarcopenia in patients with CKD via the available data.

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The clinical applicability of ultrasound technique for diagnosis of sarcopenia in hemodialysis patients

Cited by 29 publications

References 26 publications

Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta‐analysis

Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta‐analysis

The Diagnostic Value of Ultrasound of the Rectus Femoris for the diagnosis of Sarcopenia in adults: A systematic review

Effects of hormonal changes on sarcopenia in chronic kidney disease: where are we now and what can we do?

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