ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: TH-PO609

Hypercatabolism, Body Composition, and Physical Function in Advanced CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Zhou, Na, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Boucher, Robert E., University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Wei, Guo, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Caamano, Amalia, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Greene, Tom, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Beddhu, Srinivasan, University of Utah School of Medicine, Salt Lake City, Utah, United States
Background

It has been hypothesized that impaired physical function in CKD is the result of a hypercatabolic state leading to protein and energy wasting. We tested whether basal metabolic rate (BMR) is higher and accounts for impaired physical function in more advanced CKD.

Methods

We examined baseline data in 99 participants of an ongoing physical activity intervention trial (NCT 02970123) expected to be completed in Sep, 2019. Results will be updated with follow-up data for ASN presentation. Standardized protocols were used to measure BMR with indirect calorimetry (MedGem, Microlife Medical, Inc. Golden, CO) and body composition including fat free mass (FFM) and body fat% (BF%) with bioelectrical impedance analysis(Quantum X,RJL Systems, Clinton Township, MI) and physical function with 6-minutes walk distance (6-min WD).

Results

Demographic and clinical data by CKD stages are summarized in Table. Median(IQR) for BMR was 16.3 (14.8,18.2)kcal/kg/day. Mean values for FFM, BF% and 6-min WD in the entire cohort were 61±15kg, 31±10%, and 385±66m respectively. In separate multivariable linear regression models (adjusted for age, gender, race, ethnicity and diabetes), more advanced CKD was not associated with BMR or BF%, had non-significant, negative association with FFM and significant, negative association with 6-min WD (Table). The association of advanced CKD with lower 6-min WD persisted with further adjustment for BMR, FFM and %BF (Table).

Conclusion

Impaired physical function in CKD was not explained by BMR in the current study. Further studies are needed to test whether lack of anabolism rather than hypercatabolism plays a significant role in wasting and frailty in CKD.

 Stage 2/3A
N=45
Stage 3B
N=39
Stage 4/5
N=15
Clinical Characteristics
eGFR(mL/min/1.73m2)55.0±8.436.7±4.017.3±9.0
Age(yr)70±1073±962±18
Women(%)404633
White(%)989267
Hispanic(%)2513
Diabetes(%)333840
Multivariate linear regression models
BMR (kcal/kg/d)*Reference-0.06(-1.74,1.62)0.03(-2.36,2.43)
FFM(kg)*Reference1.67(-2.20,5.56)-2.20(-7.73,3.32)
BF(%)*Reference0.53(-2.61,3.68)0.14(-4.34,4.63)
6-min WD(m) Model 1*Reference-18.6(-46.4,9.3)-53.1(-93.5,-12.7)
6-min WD(m) Model 2**Reference-18.9(-48.3,10.5)-55.8(-96.6,-15.0)

*Adjusted for age, gender, race, ethnicity and diabetes **Adjusted for above plus BMR, FFM, BF(%)

Funding

  • NIDDK Support