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

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.

1. Bataille S, Serveaux M, Carreno E et al. The diagnosis of sarcopenia is mainly driven by muscle mass in hemodialysis patients. Clin Nutr 2017; 36 (6): 1654–1660. doi: 10.1016/j.clnu.2016.10.016

2. Kittiskulnam P, Chertow GM, Carrero JJ et al. Sarcopenia and its individual criteria are associated, in part, with mortality among patients on hemodialysis. Kidney Int 2017; 92 (1): 238–247. doi: 10.1016/j.kint.2017.01.024

3. Giglio J, Kamimura MA, Lamarca F et al. Association of Sarcopenia With Nutritional Parameters, Quality of Life, Hospitalization, and Mortality Rates of Elderly Patients on Hemodialysis. J Ren Nutr 2018; 28 (3): 197–207. doi: 10.1053/j.jrn.2017.12.003

4. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39 (4): 412–423. doi: 10.1093/ageing/afq034

5. Kittiskulnam P, Carrero JJ, Chertow GM et al. Sarcopenia among patients receiving hemodialysis: weighing the evidence. J Cachexia Sarcopenia Muscle 2017; 8 (1): 57–68. doi: 10.1002/jcsm.12130

6. Cao L, Morley JE. Sarcopenia Is Recognized as an Independent Condition by an International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) Code. J Am Med Dir Assoc 2016; 17 (8): 675–677. doi: 10.1016/j.jamda.2016.06.001

7. Battaglia Y, Galeano D, Cojocaru E et al. Muscle-wasting in end stage renal disease in dialysis treatment: a review. G Ital Nefrol 2016; 33 (2): gin/33.2.7

8. Messina C, Maffi G, Vitale JA et al. Diagnostic imaging of osteoporosis and sarcopenia: a narrative review. Quant Imaging Med Surg 2018; 8 (1): 86–99. doi: 10.21037/qims.2018.01.01.

9. Dehesa-López E, Correa-Rotter R, Olvera-Castillo D et al. Transcultural adaptation and validation of the Mexican version of the kidney disease questionnaire KDQOL-SF36 version 1.3. Qual Life Res 2017; 26 (1): 193–198. doi: 10.1007/s11136-016-1365-8

10. Arias-Guillén M, Perez E, Herrera P et al. Bioimpedance Spectroscopy as a Practical Tool for the Early Detection and Prevention of Protein-Energy Wasting in Hemodialysis Patients. J Ren Nutr 2018; 21: S1051–2276(18)30057-8. doi: 10.1053/j.jrn.2018.02.004

11. Popovic V, Zerahn B, Heaf JG. Comparison of Dual Energy X-ray Absorptiometry and Bioimpedance in Assessing Body Composition and Nutrition in Peritoneal Dialysis Patients. J Ren Nutr 2017; 27 (5): 355–363. doi: 10.1053/j.jrn.2017.03.003

12. Fouque D, Vennegoor M, Ter Wee P et al. EBPG Guideline on Nutrition, Nephrology Dialysis Transplantation, Volume 22, Issue suppl_2, 1 May 2007, Pages ii45–ii87, https://doi.org/10.1093/ndt/gfm020

13. Stenvinkel P, Carrero JJ, von Walden F et al. Muscle wasting in end-stage renal disease promulgates premature death: established, emerging and potential novel treatment strategies. Nephrol Dial Transplant. 2016; 31:1070–1077. DOI: 10.1093/ndt/gfv122

14. Mitch WE, Du J. Cellular mechanisms causing loss of muscle mass in kidney disease. Semin Nephrol 2004; 24: 484–487. DOI: 10.1016/j.semnephrol.2004.06.014

15. Polyzos SA, Margioris AN. Sarcopenic obesity. Hormones (Athens) 2018; 17 (3): 321–331. doi: 10.1007/s42000-018-0049-x

16. Jakovenko AA, Shestopalova OY, Rumyantsev AS, Somova VM. Comparative analysis of dual energy x-ray and bioimpedance analysis in the assessment of component composition of the body of haemodialysis patients. Diagnostic radiology and radiotherapy. 2018;(4):89–93. (In Russ.) https://doi.org/10.22328/2079-5343-2018-4-89-93

17. Fromentin C, Tome D, Nau F, Flet L et al. Dietary proteins contribute little to glucose production, even under optimal gluconeogenic conditions in healthy humans. Diabetes. 2013;62(5):1435–1442. doi:10.2337/db12-1208.