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Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality.
Nephrol Dial Transplant. 2015 Oct; 30(10):1718-25.ND

Abstract

BACKGROUND

In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the impairment of skeletal muscle mass and function thus predisposing patients to the condition of sarcopenia. Herein, we investigated the prevalence and mortality predictive power of sarcopenia, defined by three different methods, in non-dialysis-dependent (NDD) CKD patients.

METHODS

We evaluated 287 NDD-CKD patients in stages 3-5 [59.9 ± 10.5 years; 62% men; 49% diabetics; glomerular filtration rate (GFR) 25.0 ± 15.8 mL/min/1.73 m(2)]. Sarcopenia was defined as reduced muscle function assessed by handgrip strength (HGS <30th percentile of a population-based reference adjusted for sex and age) plus diminished muscle mass assessed by three different methods: (i) midarm muscle circumference (MAMC) <90% of reference value (A), (ii) muscle wasting by subjective global assessment (B) and (iii) reduced skeletal muscle mass index (<10.76 kg/m² men; <6.76 kg/m² women) estimated by bioelectrical impedance analysis (BIA) (C). Patients were followed for up to 40 months for all-cause mortality, and there was no loss of follow-up.

RESULTS

The prevalence of sarcopenia was 9.8% (A), 9.4% (B) and 5.9% (C). The kappa agreement between the methods were 0.69 (A versus B), 0.49 (A versus C) and 0.46 (B versus C). During follow-up, 51 patients (18%) died, and the frequency of sarcopenia was significantly higher among non-survivors. In crude Cox analysis, sarcopenia diagnosed by the three methods was associated with a higher hazard for mortality; however, only sarcopenia diagnosed by method C remained as a predictor of mortality after multivariate adjustment.

CONCLUSIONS

The prevalence of sarcopenia in CKD patients on conservative therapy varies according to the method applied. Sarcopenia defined as reduced handgrip strength and low skeletal muscle mass index estimated by BIA was an independent predictor of mortality in these patients.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Pereira RA
Nutrition Program and Nephrology Division, Federal University of São Paulo, São Paulo, Brazil.
Cordeiro AC
Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil.
Avesani CM
Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Carrero JJ
Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
Lindholm B
Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Amparo FC
Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil.
Amodeo C
Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil.
Cuppari L
Nutrition Program and Nephrology Division, Federal University of São Paulo, São Paulo, Brazil.
Kamimura MA
Nutrition Program and Nephrology Division, Federal University of São Paulo, São Paulo, Brazil.

MeSH

AdolescentAdultAgedAged, 80 and overComorbidityFemaleGlomerular Filtration RateHand StrengthHumansMaleMiddle AgedMuscular AtrophyPrevalencePrognosisRenal Insufficiency, ChronicSarcopeniaSurvival RateSwedenYoung Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25999376

Citation

Pereira, Raíssa A., et al. "Sarcopenia in Chronic Kidney Disease On Conservative Therapy: Prevalence and Association With Mortality." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 30, no. 10, 2015, pp. 1718-25.
Pereira RA, Cordeiro AC, Avesani CM, et al. Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. Nephrol Dial Transplant. 2015;30(10):1718-25.
Pereira, R. A., Cordeiro, A. C., Avesani, C. M., Carrero, J. J., Lindholm, B., Amparo, F. C., Amodeo, C., Cuppari, L., & Kamimura, M. A. (2015). Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 30(10), 1718-25. https://doi.org/10.1093/ndt/gfv133
Pereira RA, et al. Sarcopenia in Chronic Kidney Disease On Conservative Therapy: Prevalence and Association With Mortality. Nephrol Dial Transplant. 2015;30(10):1718-25. PubMed PMID: 25999376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. AU - Pereira,Raíssa A, AU - Cordeiro,Antonio C, AU - Avesani,Carla M, AU - Carrero,Juan J, AU - Lindholm,Bengt, AU - Amparo,Fernanda C, AU - Amodeo,Celso, AU - Cuppari,Lilian, AU - Kamimura,Maria A, Y1 - 2015/05/21/ PY - 2014/11/09/received PY - 2015/04/03/accepted PY - 2015/5/23/entrez PY - 2015/5/23/pubmed PY - 2016/4/15/medline KW - chronic kidney disease KW - handgrip strength KW - mortality KW - muscle mass KW - sarcopenia SP - 1718 EP - 25 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 30 IS - 10 N2 - BACKGROUND: In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the impairment of skeletal muscle mass and function thus predisposing patients to the condition of sarcopenia. Herein, we investigated the prevalence and mortality predictive power of sarcopenia, defined by three different methods, in non-dialysis-dependent (NDD) CKD patients. METHODS: We evaluated 287 NDD-CKD patients in stages 3-5 [59.9 ± 10.5 years; 62% men; 49% diabetics; glomerular filtration rate (GFR) 25.0 ± 15.8 mL/min/1.73 m(2)]. Sarcopenia was defined as reduced muscle function assessed by handgrip strength (HGS <30th percentile of a population-based reference adjusted for sex and age) plus diminished muscle mass assessed by three different methods: (i) midarm muscle circumference (MAMC) <90% of reference value (A), (ii) muscle wasting by subjective global assessment (B) and (iii) reduced skeletal muscle mass index (<10.76 kg/m² men; <6.76 kg/m² women) estimated by bioelectrical impedance analysis (BIA) (C). Patients were followed for up to 40 months for all-cause mortality, and there was no loss of follow-up. RESULTS: The prevalence of sarcopenia was 9.8% (A), 9.4% (B) and 5.9% (C). The kappa agreement between the methods were 0.69 (A versus B), 0.49 (A versus C) and 0.46 (B versus C). During follow-up, 51 patients (18%) died, and the frequency of sarcopenia was significantly higher among non-survivors. In crude Cox analysis, sarcopenia diagnosed by the three methods was associated with a higher hazard for mortality; however, only sarcopenia diagnosed by method C remained as a predictor of mortality after multivariate adjustment. CONCLUSIONS: The prevalence of sarcopenia in CKD patients on conservative therapy varies according to the method applied. Sarcopenia defined as reduced handgrip strength and low skeletal muscle mass index estimated by BIA was an independent predictor of mortality in these patients. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/25999376/Sarcopenia_in_chronic_kidney_disease_on_conservative_therapy:_prevalence_and_association_with_mortality_ DB - PRIME DP - Unbound Medicine ER -