Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality
Nephrol Dial Transplant
; 30(10): 1718-1725, 2015.
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1064915
Responsible library:
BR79.1
Localization: BR79.1
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 differentmethods:
(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...
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Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Chronic Kidney Disease
/
Kidney, Renal Pelvis and Ureter Cancer
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Mortality
/
Renal Insufficiency, Chronic
/
Sarcopenia
Type of study:
Prevalence study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Nephrol Dial Transplant
Year:
2015
Document type:
Article
Institution/Affiliation country:
Dante Pazzanese Institute of Cardiology/BR
/
Federal University of São Paulo/BR
/
Nutrition Institute, Rio de Janeiro State University/BR
/
Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet/SE
/
Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Center for Molecular Medicine, Karolinska Institutet/SE