Abstract
Most epidemiologic studies assessing the relationship between chronic kidney disease (CKD) and sarcopenia have been performed in dialysis patients. This study aimed to evaluate the relationship between estimated glomerular filtration rate (eGFR), proteinuria, and sarcopenia in patients with non-dialysis-dependent CKD. A total of 892 outpatients who did not show any rapid changes in renal function were enrolled in this observational cohort study. We measured the muscle mass using bioimpedance analysis and handgrip strength (HGS), and sarcopenia was defined as low HGS and low muscle mass. Sarcopenia was found in 28.1% of the patients and its prevalence decreased as the body mass index (BMI) increased; however, in patients with BMI ≥ 23 kg/m2, the prevalence did not increase with BMI. As eGFR decreased, the lean tissue index and HGS significantly decreased. However, the eGFR did not affect the fat tissue index. The risk of sarcopenia increased approximately 1.6 times in patients with eGFR < 45 mL/min/1.73 m2. However, proteinuria was not associated with sarcopenia. With a decrease in eGFR, the lean muscle mass and muscle strength decreased, and the prevalence of sarcopenia increased. In patients with late stage 3 CKD, further assessment of body composition and screening for sarcopenia may be needed.
Highlights
Most epidemiologic studies assessing the relationship between chronic kidney disease (CKD) and sarcopenia have been performed in dialysis patients
Epidemiologic studies demonstrated that muscle wasting, obesity, and volume excess are prevalent in patients with CKD, and these changes in body composition may be associated with long-term outcomes in this population[1,2,3]
Protein-energy wasting (PEW) is more common in the advanced stages of CKD, and the risk of PEW significantly increased with a decreasing estimated glomerular filtration rate[16]
Summary
Most epidemiologic studies assessing the relationship between chronic kidney disease (CKD) and sarcopenia have been performed in dialysis patients. Malnutrition, sedentary lifestyle, and inflammation are common in patients with chronic kidney disease (CKD) These are further associated with metabolically unfavorable changes in body composition leading to increased body fat, and loss of muscle mass and strength. Sarcopenia is highly prevalent (14% to 44%) and associated with poor physical performance and mortality in patients undergoing dialysis[5,6,7,8,9,10,11]; few studies have attempted to evaluate sarcopenia and its risk factors in patients with NDD-CKD12,13. We reported the risk factors of sarcopenia and their impact on long-term outcomes in hemodialysis patients and demonstrated that longitudinal muscle loss and fat gain significantly increased mortality in patients undergoing peritoneal dialysis[5,11,14,15]. We evaluated the relationship between eGFR, proteinuria and sarcopenia, and risk factors associated with sarcopenia in the population with NDD-CKD
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call