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Prevalence and Correlates of Sarcopenia among Elderly CKD Outpatients on Tertiary Care.
Nutrients. 2018 Dec 10; 10(12)N

Abstract

BACKGROUND

Sarcopenia is a widespread concern in chronic kidney disease (CKD) as well in elderly patients and is one of the main reasons why low-protein diets for this population are controversial. The aim of this study was to assess the prevalence and correlates of sarcopenia among elderly male patients affected by CKD followed up in an outpatient nephrology clinic, where moderate protein restriction (0.6⁻0.8 g/Kg/day) is routinely recommended to patients in CKD stage 3b-5 not on dialysis.

METHODS

This observational study included 80 clinically-stable male out-patients aged >60, affected by stage 3b-4 CKD. Forty patients aged ≥75 (older seniors) were compared to the other forty patients aged 60⁻74 (younger seniors). All patients underwent a comprehensive nutritional and functional assessment.

RESULTS

Older seniors showed lower serum albumin, hand-grip strength, body mass index (BMI), skeletal muscle mass, and resting energy expenditure. Protein intake was significantly lower in older seniors whereas energy intake was similar. Average daily physical activity was lower in the older seniors than in the younger ones. Sarcopenia was more prevalent in older than in younger seniors. Among older seniors, sarcopenic and non-sarcopenic ones differed in age and performance on the Six-Minute Walk test, whereas the estimated glomerular filtration rate (eGFR), biochemistry, dietary protein, and energy intakes were similar.

CONCLUSIONS

Older senior CKD male patients have lower muscle mass, muscle strength, and physical capacity and activity levels, with a higher prevalence of sarcopenia than younger patients. This occurs at the same residual renal function and metabolic profile and protein intake. Energy intake was at the target in both subgroups. In this CKD cohort, sarcopenia was associated with age and physical capacity, but not with eGFR or dietary intakes.

Authors+Show Affiliations

Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy. dalessandroclaudia@gmail.com.Department of Clinical and Biological Sciences, University of Torino, 10124 Torino, Italy. gbpiccoli@yahoo.it. Nephrologie, CH Le Mans, 72037 Le Mans, France. gbpiccoli@yahoo.it.Nephrology, Transplant and Dialysis Unit, AOUP, 35233 Pisa, Italy. m.barsotti63@gmail.com.Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy. serenatassi@msn.com.Nephrology, Transplant and Dialysis Unit, AOUP, 35233 Pisa, Italy. d.giannese@ao-pisa.toscana.it.Section of Statistics, AOUP, 56100 Pisa, Italy. morganti@ao-pisa.toscana.it.Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy. adamasco.cupisti@med.unipi.it.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

30544657

Citation

D'Alessandro, Claudia, et al. "Prevalence and Correlates of Sarcopenia Among Elderly CKD Outpatients On Tertiary Care." Nutrients, vol. 10, no. 12, 2018.
D'Alessandro C, Piccoli GB, Barsotti M, et al. Prevalence and Correlates of Sarcopenia among Elderly CKD Outpatients on Tertiary Care. Nutrients. 2018;10(12).
D'Alessandro, C., Piccoli, G. B., Barsotti, M., Tassi, S., Giannese, D., Morganti, R., & Cupisti, A. (2018). Prevalence and Correlates of Sarcopenia among Elderly CKD Outpatients on Tertiary Care. Nutrients, 10(12). https://doi.org/10.3390/nu10121951
D'Alessandro C, et al. Prevalence and Correlates of Sarcopenia Among Elderly CKD Outpatients On Tertiary Care. Nutrients. 2018 Dec 10;10(12) PubMed PMID: 30544657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and Correlates of Sarcopenia among Elderly CKD Outpatients on Tertiary Care. AU - D'Alessandro,Claudia, AU - Piccoli,Giorgina Barbara, AU - Barsotti,Massimiliano, AU - Tassi,Serena, AU - Giannese,Domenico, AU - Morganti,Riccardo, AU - Cupisti,Adamasco, Y1 - 2018/12/10/ PY - 2018/11/01/received PY - 2018/11/27/revised PY - 2018/12/04/accepted PY - 2018/12/15/entrez PY - 2018/12/14/pubmed PY - 2019/2/23/medline KW - CKD KW - aging KW - functional capacity KW - physical performance KW - protein restriction KW - sarcopenia JF - Nutrients JO - Nutrients VL - 10 IS - 12 N2 - BACKGROUND: Sarcopenia is a widespread concern in chronic kidney disease (CKD) as well in elderly patients and is one of the main reasons why low-protein diets for this population are controversial. The aim of this study was to assess the prevalence and correlates of sarcopenia among elderly male patients affected by CKD followed up in an outpatient nephrology clinic, where moderate protein restriction (0.6⁻0.8 g/Kg/day) is routinely recommended to patients in CKD stage 3b-5 not on dialysis. METHODS: This observational study included 80 clinically-stable male out-patients aged >60, affected by stage 3b-4 CKD. Forty patients aged ≥75 (older seniors) were compared to the other forty patients aged 60⁻74 (younger seniors). All patients underwent a comprehensive nutritional and functional assessment. RESULTS: Older seniors showed lower serum albumin, hand-grip strength, body mass index (BMI), skeletal muscle mass, and resting energy expenditure. Protein intake was significantly lower in older seniors whereas energy intake was similar. Average daily physical activity was lower in the older seniors than in the younger ones. Sarcopenia was more prevalent in older than in younger seniors. Among older seniors, sarcopenic and non-sarcopenic ones differed in age and performance on the Six-Minute Walk test, whereas the estimated glomerular filtration rate (eGFR), biochemistry, dietary protein, and energy intakes were similar. CONCLUSIONS: Older senior CKD male patients have lower muscle mass, muscle strength, and physical capacity and activity levels, with a higher prevalence of sarcopenia than younger patients. This occurs at the same residual renal function and metabolic profile and protein intake. Energy intake was at the target in both subgroups. In this CKD cohort, sarcopenia was associated with age and physical capacity, but not with eGFR or dietary intakes. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/30544657/Prevalence_and_Correlates_of_Sarcopenia_among_Elderly_CKD_Outpatients_on_Tertiary_Care_ DB - PRIME DP - Unbound Medicine ER -