Yunan Zhou1, Matthias Hellberg1, Philippa Svensson1, Peter Höglund2, Naomi Clyne1. 1. Lund University, Skåne University Hospital, Department of Clinical Sciences, Division of Nephrology, Lund, Sweden. 2. Lund University, Skåne University Hospital, Department of Laboratory Medicine, Division of Clinical Chemistry & Pharmacology, Lund, Sweden.
Abstract
Background: Sarcopenia and poor physical function are common in patients with chronic kidney disease (CKD). Our aim was to investigate the relationships between muscle mass and measured glomerular filtration rate (GFR) and between muscle mass and strength and balance, respectively, in patients with CKD stages 3-5. Methods: This is a baseline data analysis of a randomized controlled clinical trial. A total of 148 adult patients with an estimated GFR <30 mL/min/1.72 m2, not on renal replacement therapy, irrespective of the number of comorbidities were included from the Department of Nephrology, Skåne University Hospital, Lund, from 2011 to 2016. Body composition was measured by dual-energy X-ray absorptiometry (DEXA). GFR was measured by iohexol clearance. Balance was measured by functional reach and the Berg balance test and strength by handgrip strength and isometric quadriceps strength. Results: Measured GFR ranged from 8 to 55 mL/min/1.73 m2. Lean mass (P < 0.05), fat mass (P < 0.05), appendicular skeletal muscle (P < 0.001) and appendicular skeletal muscle index (P < 0.05) were associated with GFR. Functional reach was associated with leg lean mass (P < 0.05) and the Berg balance test score was associated with trunk lean mass (P < 0.05). Handgrip strength was associated with arm lean mass (P < 0.001). Isometric quadriceps strength was associated with leg lean mass (P < 0.001). More men (44%) suffered from low muscle mass than women (22%), whereas more women (36%) suffered from low muscle strength than men (26%). However, when combining both, men (16%) suffered from sarcopenia to a greater extent than women (8%). Conclusions: Among patients with CKD stages 3-5, loss of lean body mass, especially appendicular skeletal muscle, was significantly related to GFR decline. Two important markers of physical function, balance and strength, were significantly related to muscle mass. Moreover, men were more prone to sarcopenia than women during kidney function decline.
RCT Entities:
Background: Sarcopenia and poor physical function are common in patients with chronic kidney disease (CKD). Our aim was to investigate the relationships between muscle mass and measured glomerular filtration rate (GFR) and between muscle mass and strength and balance, respectively, in patients with CKD stages 3-5. Methods: This is a baseline data analysis of a randomized controlled clinical trial. A total of 148 adult patients with an estimated GFR <30 mL/min/1.72 m2, not on renal replacement therapy, irrespective of the number of comorbidities were included from the Department of Nephrology, Skåne University Hospital, Lund, from 2011 to 2016. Body composition was measured by dual-energy X-ray absorptiometry (DEXA). GFR was measured by iohexol clearance. Balance was measured by functional reach and the Berg balance test and strength by handgrip strength and isometric quadriceps strength. Results: Measured GFR ranged from 8 to 55 mL/min/1.73 m2. Lean mass (P < 0.05), fat mass (P < 0.05), appendicular skeletal muscle (P < 0.001) and appendicular skeletal muscle index (P < 0.05) were associated with GFR. Functional reach was associated with leg lean mass (P < 0.05) and the Berg balance test score was associated with trunk lean mass (P < 0.05). Handgrip strength was associated with arm lean mass (P < 0.001). Isometric quadriceps strength was associated with leg lean mass (P < 0.001). More men (44%) suffered from low muscle mass than women (22%), whereas more women (36%) suffered from low muscle strength than men (26%). However, when combining both, men (16%) suffered from sarcopenia to a greater extent than women (8%). Conclusions: Among patients with CKD stages 3-5, loss of lean body mass, especially appendicular skeletal muscle, was significantly related to GFR decline. Two important markers of physical function, balance and strength, were significantly related to muscle mass. Moreover, men were more prone to sarcopenia than women during kidney function decline.
Authors: Julien Hogan; Michael F Schneider; Rima Pai; Michelle R Denburg; Amy Kogon; Ellen R Brooks; Frederick J Kaskel; Kimberly J Reidy; Jeffrey M Saland; Bradley A Warady; Susan L Furth; Rachel E Patzer; Larry A Greenbaum Journal: Pediatr Nephrol Date: 2020-01-13 Impact factor: 3.714
Authors: Thomas J Wilkinson; Joanne Miksza; Thomas Yates; Courtney J Lightfoot; Luke A Baker; Emma L Watson; Francesco Zaccardi; Alice C Smith Journal: J Cachexia Sarcopenia Muscle Date: 2021-05-05 Impact factor: 12.063
Authors: Geraldo José de Amorim; Cinthia Katiane Martins Calado; Bruno Carlos Souza de Oliveira; Renata Patricia Oliveira Araujo; Tayrine Ordonio Filgueira; Matheus Santos de Sousa Fernandes; Angela Castoldi; Gisele Vajgel; Lucila Maria Valente; José Luiz de Lima-Filho; Paulo Roberto Cavalcanti Carvalho; Fabricio Oliveira Souto Journal: Front Med (Lausanne) Date: 2022-04-07