Abstract
BackgroundLoss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria. Thus, we investigated the prevalence of sarcopenia among community-dwelling older adults according to kidney function and grade of albuminuria. We also explored differences in the prevalence of sarcopenia according to three different equations for the estimation of glomerular filtration rate (eGFR).MethodsA cross-sectional analysis of 1420 community-dwelling older adults (≥75 years old) included in the SCOPE study, a multicenter prospective cohort study, was conducted. Comprehensive geriatric assessment including short physical performance battery (SPPB), handgrip strength test and bioelectrical impedance analysis (BIA) was performed. Sarcopenia was defined using the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). eGFR was calculated using Berlin Initiative Study (BIS), Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and Full Age Spectrum (FAS) equations, and urinary albumin-to-creatinine ratio (ACR) was collected to categorize CKD according to Kidney Disease Improving Global Outcomes guidelines.ResultsMedian age was 79.5 years (77.0–83.0), 804 (56.6%) were women. Using EWGSOP2 definition, 150 (10.6%) participants met diagnostic criteria for sarcopenia. Moreover, 85 (6%) participants had severe sarcopenia. Sarcopenia was more prevalent in participants with more advanced stages of CKD according to BIS eq. (9.6% in stages 1 and 2 and 13.9% in stages 3a, 3b and 4, p = 0.042), and also according to CKD-EPI (9.8% vs. 14.2%, p = 0.042) and FAS although not reaching statistical signification (9.8% vs. 12.7%, p = 0.119). Thus, differences in prevalence are observed among CKD categories as estimated by different equations. Prevalence of sarcopenia was also higher with increasing albuminuria categories: 9.3% in normoalbuminuric, 13.2% in microalbuminuric and 16.8% in macroalbuminuric participants, (p = 0.019).ConclusionsSarcopenia is common among community-dwelling older adults, especially among those with more advanced CKD categories, with prevalence estimates differing slightly depending on the equation used for the estimation of eGFR; as well as among those with higher albuminuria categories.
Highlights
Loss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria
Sarcopenia was more prevalent in participants with more advanced stages of CKD according to Berlin Initiative Study (BIS) eq (9.6% in stages 1 and 2 and 13.9% in stages 3a, 3b and 4, p = 0.042), and according to Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) (9.8% vs. 14.2%, p = 0.042) and Full Age Spectrum (FAS) not reaching statistical signification (9.8% vs. 12.7%, p = 0.119)
Sarcopenia is common among community-dwelling older adults, especially among those with more advanced CKD categories, with prevalence estimates differing slightly depending on the equation used for the estimation of estimation of glomerular filtration rate (eGFR); as well as among those with higher albuminuria categories
Summary
Loss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria. The ageing process is characterised by quantitative and qualitative changes in body composition Those affecting skeletal muscle mass and function are among the most relevant [1]. Sarcopenia is a muscle disease rooted in adverse muscle changes that accrue across a lifetime and is common among older adults, while it can occur earlier in life. It represents a major cause of falls, is associated with other adverse health outcomes and predicts disability and mortality in older people [2]. Sarcopenia is considered probable when low muscle strength is detected, confirmed when low muscle mass is evidenced, and severe when low physical performance is present
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