scholarly journals Sarcopenic Obesity in Chronic Kidney Disease: Challenges in Diagnosis using Different Diagnostic Criteria

2021 ◽  
Author(s):  
Natália Tomborelli Bellafronte ◽  
Amanda de Queirós Mattoso Ono ◽  
Paula Garcia Chiarello
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diagnostic Criteria ◽  
Muscle Mass ◽  
Fat Mass ◽  
Handgrip Strength ◽  
Sarcopenic Obesity ◽  
Obesity Prevalence ◽  
Transplant Patients ◽  
Muscle Impairment

Obesity and muscle impairment (low muscle mass or strength) are present in chronic kidney disease (CKD) and associated to worse prognosis. However, the various existing definitions for these conditions make the diagnosis variable. The aim of the study was to evaluate the agreement between diagnostic criteria for sarcopenic obesity and its components in CKD. Two hundred and sixty seven patients with CKD were included in the study. We assessed body composition by dual energy X-ray absorptiometry (DXA) and muscle function by handgrip strength (HGS); adiposity by BMI, waist circumference (WC), fat mass index (FMI), and percentage of fat mass (%FM). Diagnosis of muscle impairment was made by HGS, appendicular lean mass (ALM) and index (ALMI); obesity by BMI, WC, FMI and %FM, and sarcopenic obesity was diagnosed by concomitant presence of muscle impairment and obesity. Prevalence of muscle impairment varied from 11 to 50%, higher when low muscle mass criteria was used. Prevalence of obesity varied from 26 to 62%, higher when WC and %FM criteria was used. Prevalence of sarcopenic obesity varied from 2 to 23%. Women were more affected by sarcopenic obesity. Muscle impairment and sarcopenic obesity were more prevalent among patients on hemodialysis and obesity among non-dialysis-dependent and kidney transplant patients. The agreement was poor between muscle mass and strength criteria; substantial between FMI, BMI, and %FM and only fair between WC and the others measures; for sarcopenic obesity, varied from poor to almost perfect. Significant differences were found among the various diagnostic criteria that are used in the diagnosis of sarcopenic obesity.

Sarcopenic obesity in chronic kidney disease – challenges in diagnosis using different diagnostic criteria

2021 ◽  
Vol 46 ◽  
pp. S679-S680
Author(s):  
N.T. Bellafronte ◽  
L. Vega-Piris ◽  
G.B. Cuadrado ◽  
P.G. Chiarello
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diagnostic Criteria ◽  
Sarcopenic Obesity

scholarly journals Late stage 3 chronic kidney disease is an independent risk factor for sarcopenia, but not proteinuria

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jung Nam An ◽  
Jwa-Kyung Kim ◽  
Hyung-Seok Lee ◽  
Sung Gyun Kim ◽  
Hyung Jik Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Late Stage ◽  
Handgrip Strength ◽  
Epidemiologic Studies ◽  
The Body ◽  
Rapid Changes ◽  
Observational Cohort ◽  
The Relationship

AbstractMost 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.

scholarly journals Effects of Low Muscle Mass on Albuminuria and Chronic Kidney Disease in Patients With Type 2 Diabetes: The Korean Sarcopenic Obesity Study (KSOS)

2017 ◽  
Vol 73 (3) ◽  
pp. 386-392 ◽  
Author(s):  
Hye Soo Chung ◽  
Soon Young Hwang ◽  
Ju Hee Choi ◽  
Hyun Jung Lee ◽  
Hye Jin Yoo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Sarcopenic Obesity

scholarly journals Effect of Low Skeletal Muscle Mass and Sarcopenic Obesity on Chronic Kidney Disease in Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Da Hea Seo ◽  
Young Ju Suh ◽  
Yongin Cho ◽  
Seong Hee Ahn ◽  
Seongha Seo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Bioelectrical Impedance ◽  
Sarcopenic Obesity ◽  
Increased Risk

Abstract The causal relationship between low muscle mass and development of chronic kidney disease (CKD) is uncertain in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between low muscle mass or sarcopenic obesity and the risk of incident CKD in patients with T2DM. A total of 3,123 patients with T2DM with preserved renal function were followed up for incident CKD. Skeletal muscle mass was estimated from bioelectrical impedance analysis. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73m2. Sarcopenic obesity was defined as the coexistence of sarcopenia and abdominal obesity. During 8.9 years of follow-up, 530 (17.0%) patients developed incident CKD. When subjects were divided into three groups based on sex-specific tertiles, lower muscle mass was not associated with an increased risk of incident CKD after adjustment for risk factors. However, when patients were divided into four groups according to the presence of sarcopenia and obesity, sarcopenic obesity was associated with an increased risk of incident CKD (adjusted hazard ratio 1.77; 95% confidence interval 1.24-2.51; p=0.001) compared to the other groups. Sarcopenic obesity, but not low muscle mass alone, may increase the risk of CKD in patients with T2DM.

scholarly journals Bed-side measures for diagnosis of low muscle mass, sarcopenia, obesity, and sarcopenic obesity in patients with chronic kidney disease under non-dialysis-dependent, dialysis dependent and kidney transplant therapy

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242671
Author(s):  
Natália Tomborelli Bellafronte ◽  
Gabriel Ruiz Sizoto ◽  
Lorena Vega-Piris ◽  
Paula Garcia Chiarello ◽  
Guillermina Barril Cuadrado
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Area Under The Curve ◽  
Bioelectrical Impedance ◽  
Fat Free Mass ◽  
Sarcopenic Obesity ◽  
Anthropometric Parameters ◽  
Hand Grip ◽  
European Working

Muscle depletion and sarcopenic obesity are related to a higher morbimortality risk in chronic kidney disease (CKD). We evaluated bed-side measures/indexes associated with low muscle mass, sarcopenia, obesity, and sarcopenic obesity in CKD and proposed cutoffs for each parameter. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People revised consensus applying dual energy X-ray absorptiometry (DXA) and hand grip strength (HGS), and obesity according to the International Society for Clinical Densitometry. Anthropometric parameters including calf (CC) and waist (WC) circumferences and WC/height (WC/H); bioelectrical impedance data including appendicular fat free mass (AFFM) and fat mass index (FMI) were assessed. ROC analysis and area under the curve (AUC) were applied for performance analyses. AFFM and CC presented the best performances for low muscle mass diagnosis–AFFM AUC for women was 0.96 and for men, 0.94, and CC AUC for women was 0.89 and for men, 0.85. FMI and WC/H were the best parameters for obesity diagnosis–FMI AUC for women was 0.99 and for men, 0.96, and WC/H AUC for women was 0.94 and for men, 0.95. The cutoffs (sensibility and specificity, respectively) for women were AFFM≤15.87 (90%; 96%), CC≤35.5 (76%; 94%), FMI>12.58 (100%; 93%), and WC/H>0.66 (91%; 84%); and for men, AFFM≤21.43 (98%; 84%), CC≤37 (88%; 69%), FMI>8.82 (93%; 88%), and WC/H>0.60 (95%; 80%). Sensibility and specificity for sarcopenia diagnosis were for AFFM+HGS in women 85% and 99% and in men, 100% and 99%; for CC+HGS in women 85% and 99% and in men, 100% and 100%; and for sarcopenic obesity were for FMI+AFFM in women 75% and 97% and in men, 75% and 95%. The tested bed-side measures/indexes presented excellent performance.

scholarly journals Correction: Bed-side measures for diagnosis of low muscle mass, sarcopenia, obesity, and sarcopenic obesity in patients with chronic kidney disease under non-dialysis-dependent, dialysis dependent and kidney transplant therapy

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250186
Author(s):  
Natália Tomborelli Bellafronte ◽  
Gabriel Ruiz Sizoto ◽  
Lorena Vega-Piris ◽  
Guillermina Barril Cuadrado ◽  
Paula Garcia Chiarello
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Transplant ◽  
Muscle Mass ◽  
Sarcopenic Obesity

Sarcopenia is an actual problem in chronic kidney disease of the 5d stage

2020 ◽  
Vol 24 (1) ◽  
pp. 60-66
Author(s):  
I. V. Lavrishcheva ◽  
A. Sh. Rumyantsev ◽  
M. V. Zakharov ◽  
N. N. Kulaeva ◽  
V. M. Somova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Chronic Kidney Disease Stage ◽  
Age Groups ◽  
Disease Stage ◽  
Actual Problem ◽  
European Working ◽  
Low Performance ◽  
6 Minute Walk Test

BACKGROUND. The lack of data on the epidemiology of presarcopenia/sarcopenia leads to an underestimation of the role of this condition in the structure of morbidity and mortality of haemodialysis patients in theRussian Federation. THE AIM: to study the epidemiological aspects of presarcopenia /sarcopenia in patients with chronic kidney disease stage 5d. PATIENTS AND METHODS. This study comprised 317 patients receiving programmed bicarbonate haemodialysis for 8.2 ± 5.1 years, among them 171 women and 146 men, the average age was 57.1 ± 11.3 years. The assessment of the presence of sarcopenia was performed using the method recommended by the European Working Group on Sarcopenia in Older People. RESULTS. The prevalence of presarcopenia was 0.7 % and sarcopenia 29.6 %. The incidence of skeletal muscle mass deficiency according to muscle mass index (IMM) was 30.3 %, 48.7 % showed a decrease in muscle strength according to dynamometry, and low performance of skeletal muscles according to 6 minute walk test was determined in 42.8 %. Sarcopenia patients were significantly characterized by lower body mass index, as well as higher body fat mass values. The duration of haemodialysis (χ2 = 22.376, p = 0.0001) and the patient's age (χ2 = 10.545 p = 0.014) were an independent risk factors for the development of sarcopenia. CONCLUSION. Sarcopenia is recorded more frequently in hemodialysis patients than presarcopenia. Its prevalence increases among patients of older age groups and with a hemodialysis duration of more than 5 years. The age and experience of dialysis make their independent contribution to the development of this syndrome.

scholarly journals Optimal Protein Intake in Pre-Dialysis Chronic Kidney Disease Patients with Sarcopenia: An Overview

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1205
Author(s):  
Yoshitaka Isaka
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Exercise Therapy ◽  
Protein Intake ◽  
Renin Angiotensin System ◽  
Protein Restriction ◽  
Ckd Stage ◽  
End Stage

Multi-factors, such as anorexia, activation of renin-angiotensin system, inflammation, and metabolic acidosis, contribute to malnutrition in chronic kidney disease (CKD) patients. Most of these factors, contributing to the progression of malnutrition, worsen as CKD progresses. Protein restriction, used as a treatment for CKD, can reduce the risk of CKD progression, but may worsen the sarcopenia, a syndrome characterized by a progressive and systemic loss of muscle mass and strength. The concomitant rate of sarcopenia is higher in CKD patients than in the general population. Sarcopenia is also associated with mortality risk in CKD patients. Thus, it is important to determine whether protein restriction should be continued or loosened in CKD patients with sarcopenia. We may prioritize protein restriction in CKD patients with a high risk of end-stage kidney disease (ESKD), classified to stage G4 to G5, but may loosen protein restriction in ESKD-low risk CKD stage G3 patients with proteinuria <0.5 g/day, and rate of eGFR decline <3.0 mL/min/1.73 m2/year. However, the effect of increasing protein intake alone without exercise therapy may be limited in CKD patients with sarcopenia. The combination of exercise therapy and increased protein intake is effective in improving muscle mass and strength in CKD patients with sarcopenia. In the case of loosening protein restriction, it is safe to avoid protein intake of more than 1.5 g/kgBW/day. In CKD patients with high risk in ESKD, 0.8 g/kgBW/day may be a critical point of protein intake.

Relevance of Chronic Kidney Disease Classification (K/DOQI) in Renal Transplant Patients

2006 ◽  
Vol 38 (8) ◽  
pp. 2402-2403 ◽  
Author(s):  
G. Fernandez-Fresnedo ◽  
A. de Francisco ◽  
J.C. Ruiz ◽  
J.G. Cotorruelo ◽  
C.G. Alamillo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Transplant ◽  
Kidney Disease ◽  
Disease Classification ◽  
Transplant Patients ◽  
Renal Transplant Patients
Sign in / Sign up

Export Citation Format

Share Document