Sarcopenia and Mortality in Patients With Chronic Non-dialytic Renal Disease: Systematic Review and Meta-Analysis.

OBJECTIVE: To analyze the results of prospective studies on the presence of sarcopenia and its association with cardiovascular events and mortality in patients with non-dialysis-dependent chronic renal disease. METHODS: This study used the PRISMA protocol for systematic review. The systematic review and meta-analysis protocol was recorded in the prospective record of systematic reviews by PROSPERO International: CRD42019120391. DATA SOURCES: MEDLINE via PubMed, Embase, Cochrane Library, CINAHL, Scopus, Web of Science and LILACS from December 2018 to April 20, 2019, with the survey results updated in January 2021. DATA ANALYSIS: Random effect models were calculated to compare the results due to high heterogeneity identified. RESULTS: The survey identified 951 studies. Of these, 392 were removed by duplicates and 559 references were selected for analysis. In the stage of evaluating titles and abstracts, 555 articles were excluded because they did not include inclusion criteria related to the population and study design, leaving 4 articles that were included in the systematic review and meta-analysis. A meta-analysis identified that the presence of sarcopenia increased the risk of mortality by 143%. CONCLUSION(S): The meta-analysis identified the influence of sarcopenia on mortality in non-dialysis-dependent chronic renal disease.

Phase angle as a marker for sarcopenia in cirrhosis.

BACKGROUND: In patients with cirrhosis nutritional disturbances can progress to sarcopenia, worsening the disease prognosis. Phase angle (PA) may be a useful marker for sarcopenia in this clinical population reflecting the cellular integrity level. This cross-sectional and prospective study evaluated the association between low PA values and clinical/nutritional variables in cirrhosis with emphasis on sarcopenia. METHODS: Male patients with cirrhosis (n = 122) were grouped according their PA values (>4.9° or ≤ 4.9°) after performing electrical bioimpedance. Sarcopenia diagnosis was assessed by considering appendicular skeletal muscle mass indexes <7.0 kg/m2 (dual-energy X-ray absorptiometry) and non-dominant handgrip strength (HGS) < 27 kg (dynamometry). Logistic regression model was used to examine the correlation between clinical/nutritional variables and PA values and the ROC curve area was calculated to identify the power of PA values in predicting sarcopenia. RESULTS: Sarcopenic patients presented lower HGS (19.57 vs. 30.55, p = 0.000), PA value (4.18 vs. 5.39, p = 0.005), SM (17.17 vs. 22.00 (p = 0.05), reactance (36.76 vs. 51.11, p = 0.023), and albumin (3.10 vs. 3.75, p = 0.037), as well as higher resistance values (512.56 vs. 457.01, p = 0.021) and CRP levels (7.89 vs. 3.53, p = 0.040) than non-sarcopenic patients. Furthermore, the PA values ≤ 5.05° were able to predict with high sensitivity the diagnosis of sarcopenia in the studied population. CONCLUSION: In male patients with cirrhosis, low PA values may reflect disease prognosis by correlating to sarcopenia among other clinical/nutritional changes and performed as a good marker for this main nutritional complication when ≤5.05°.