Patients with chronic kidney disease (CKD) who have sarcopenia are at higher risk for death compared with those who do not have the condition, according to data presented at the European Renal Association-European Dialysis and Transplant Association 2020 virtual congress.
Thomas Wilkinson, PhD, of the University of Leicester in Leicester, UK, and colleagues used the UK Biobank database to identify 426,839 individuals. Of these, 7623 had non-dialysis-dependent CKD (estimated glomerular filtration rate below 60 mL/min/1.73 m2) and 419,216 did not and served as a comparator group. The investigators identified “probable sarcopenia” in 9% of CKD patients compared with 5% of the non-CKD group; they identified “confirmed sarcopenia” in 0.3% of the CKD group compared with 0.2% in the non-CKD group. In addition, 0.2% of the CKD patients had “severe sarcopenia” compared with 0.03% of the non-CKD group.
Among the CKD patients, probable, confirmed, and severe sarcopenia were significantly associated with an approximately 2-, 5-, and 5-fold increased risk of all-cause mortality compared with the absence of sarcopenia in adjusted analyses.
“Regardless of the criteria used, CKD patients with sarcopenia were approximately 2-5 times more likely to die than those without sarcopenia,” Dr Wilkinson’s team concluded in a study abstract. “Worryingly, the risk of sarcopenia was elevated even in patients with early stage mild strength, is an important predictor of mortality in early non-dialysis CKD. Measuring sarcopenia as standard practice may identify those most at risk of future adverse events and in need of appropriate interventions to mitigate its negative effects.”
The investigators defined probable sarcopenia as low handgrip strength (HGS): less than 27 kg in male patients and less than 16 kg in female patients; confirmed sarcopenia as low HGS plus low muscle mass (appendicular lean mass of less than 7 and less than 5.5 kg/m2 in male and female patients, respectively, as measured by bioelectrical impedance); and severe sarcopenia as low HGS and muscle mass plus slow gait speed.
Wilkinson T, Miksza J, Baker L, et al. Sarcopenia, chronic kidney disease and risk of mortality: Findings from 426,839 individuals in the UK Biobank. Presented at the European Renal Association-European Dialysis and Transplant Association 2020 virtual congress. Abstract MO023. https://www.era-edta.org/en/virtual-meeting/#!resources/sarcopenia-chronic-kidney-disease-and-risk-of-mortality-findings-from-426-839-individuals-in-the-uk-biobank