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2017 ; 12
(4
): e0176230
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Sarcopenia in patients with chronic kidney disease not yet on dialysis: Analysis
of the prevalence and associated factors
#MMPMID28448584
Souza VA
; Oliveira D
; Barbosa SR
; Corrêa JODA
; Colugnati FAB
; Mansur HN
; Fernandes NMDS
; Bastos MG
PLoS One
2017[]; 12
(4
): e0176230
PMID28448584
show ga
INTRODUCTION: Sarcopenia is a chronic condition that is associated with aging and
characterized by a reduction of muscle mass, strength, and function. Sarcopenia
is prevalent in patients with chronic kidney disease (CKD) and associated with
increased morbidity and mortality, as well as cardiovascular complications.
OBJECTIVES: To investigate the prevalence of sarcopenia in patients with CKD not
yet on dialysis and its correlation with clinical and laboratory variables and
inflammatory markers. METHODS: A total of 100 patients of both sexes aged over 18
were evaluated. Sarcopenia was defined using the criteria of the European Working
Group on Sarcopenia in Older People (EWGSOP) and of the Foundation for the
National Institutes of Health (FNIH) Sarcopenia Project. Sociodemographic and
clinical data, activities of daily living, functional capacity, and physical
activity were also evaluated. Inflammation was assessed by the serum levels of
high-sensitivity C-reactive protein (hsCRP) and interleukin (IL) 4 and 6.
RESULTS: The prevalence of sarcopenia was 11.9% and 28.7% using the EWGSOP and
FNIH criteria, respectively. Sarcopenia was more prevalent in the more advanced
stages of CKD (34.5% in stages 2 and 3A; and 65.5% in stages 3B, 4, and 5) and
associated with worse performance in activities of daily living (p = 0.049),
lower walking speeds (p < 0.001), and higher body mass indexes (BMIs) (p = 0.001)
in the non-adjusted model. In addition, patients with sarcopenia had lower
functional capacity (p = 0.012) and higher prevalence of physical inactivity (p =
0.041) compared with patients without sarcopenia. After adjustment for
confounding variables, sarcopenia was still significantly correlated with walking
speed (p = 0.004) and BMI (p = 0.002). HsCRP levels were inversely correlated
with appendicular lean mass adjusted for BMI (p = 0.007) and were also positively
associated with BMI (p = 0.001). IL4 levels were positively correlated with
walking speed (p = 0.007) and lean mass in the lower limbs (p = 0.022).
CONCLUSIONS: Sarcopenia is common in patients with CKD, particularly in the most
advanced stages of the disease. We observed an association between the levels of
inflammatory markers and peripheral lean body mass, physical performance, and
BMI. This association between sarcopenia and modifiable factors highlights the
importance of early diagnosis and the implementation of therapeutic measures to
minimize adverse outcomes in patients with CKD not yet on dialysis.