Kidney Week

Abstract: FR-PO546

Presarcopenia and Sarcopenia as Predictors of Hospitalization-Free Survival in Patients with CKD

Session Information

• Physical Activity, Body Composition, Metabolism: Clinical
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Lee, So-young, CHA Bundang Medical Center, CHA Univ., Seongnam, Gyeonggi-do, Korea (the Republic of)

So-young Lee,

• Yang, Dong Ho, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, Korea (the Republic of)

Dong Ho Yang,

• Sung, Min ji, CHA Bundang Medical Center, Cha university, Seongnam, Gyeonggi-do, Korea (the Republic of)

Min ji Sung,

• Kang, Jun mo, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, Korea (the Republic of)

Jun mo Kang,

• Choi, Yubum, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, Korea (the Republic of)

Yubum Choi,

• Ahn, Wooyeol, CHA University, Seongnam-si, Korea (the Republic of)

Wooyeol Ahn,

• Lee, Soonchul, CHA Bundang Medical Center, CHA university, Seongnam, Gyeonggi-do, Korea (the Republic of)

Soonchul Lee,

Background

Sarcopenia is defined as the degenerative loss of skeletal muscle mass, and strength associated with aging. In this article, we compared prevalence of sarcopenia using three different skeletal muscle mass indices in predialysis and dialysis patients with chronic kidney disease (CKD), and sought to the relationship with clinical outcomes.

Methods

179 patients were recruited (114 male, 65 female, 103 predialysis, 76 dialysis) and followed prospectively for up to 3 years. Appendicular skeletal muscle mass (ASM) was measured by bioimpedance analysis (Inbody 620, In-body, Seoul, Korea). Weight (wt) adjusted, height square (ht²) adjusted, or body mass index (BMI) adjusted ASM were assessed in all subjects. Hand grip strength and walking speed were measured. Frailty phenotypes were examed in all subjects. Sarcopenia was considered present when subjects had low handgrip strength accompanied by low adjusted ASM. Those who showed only low hand grip or muscle volume loss were categorized as presarcopenia.

Results

9.5%, 4.5%, or 2.8% of the patients had sarcopenia, while 55.9%, 57.5%, or 58.7% of the patients were categorized as presarcopenic status according to three different indices (ASM/wt, ASM/ht², or ASM/BMI respectively). ASM/wt index showed significant correlation with age, handgrip strength, HOMA-IR and frailty score. During follow-up, 56 patients were hospitalized (cardiovascular 30.3%; infectious disease 23.2%). Multivariate cox proportional hazards models also demonstrated that the risk of hospitalization was significantly higher for CKD patients who were categorized as sarcopenic (hazard ratio [HR], 9.11 ; 95% confidence interval [CI], 2.295 – 25.182; P < 0.001) or presarcopenic (HR, 2.48 ; 95% CI, 1.180 – 5.230; P = 0.017) than normal status according to ASM/wt index

Conclusion

ASM/wt index showed best relationship with age, muscle strength, insulin resistance and frailty. Sarcopenia and presarcopenia defined using ASM/wt index predicted poorer hospitalization-free survival in patients with CKD. This work was supported by a National Research Foundation grant of Korea (NRF-2016R1C1B1013814) funded by the Korea government.

Funding

• Government Support - Non-U.S.