Sarcopenia in Non-Dialysis Chronic Kidney Disease Patients: Prevalence and Associated Factors

Background: Sarcopenia is related to morbidity and mortality in non-dialysis Chronic Kidney Disease (ND-CKD) patients; however, the pathophysiology of sarcopenia remains unclear. The study aimed to assess the prevalence and factors associated with sarcopenia in ND-CKD individuals.

Methods: We cross-sectionally evaluated 139 prevalent ND-CKD patients attending our outpatient clinic at Hospital das Clínicas of the Federal University of Pernambuco, between April and October 2019. Patients older than 18 years old and at G3-G5 CKD stages were included. Hand grip strength, Muscle Mass appendicular Index, and Gait Speed (GS) were defined by the standards of the European Working Group on Sarcopenia in Older People 2 guideline.

Results: Sarcopenia prevalence was 20.9% and severe sarcopenia 2.9%. Sarcopenic were mostly found in elderly ones (64.8 ± 13.5 years vs. 54.9 ± 12.8 years, < 0.001), revealing lower body mass index [26.1 (6.8) vs. 28.6 (6.2), = 0.023], lower phase angle (PhA) [4.50 (1.10) vs. 5.60 (1.20), < 0.001] and lower GS [1.00 (0.50) vs. 1.40 (0.4), < 0.001]. They also presented lower serum creatinine levels [2.40 (1.50) vs. 3.0 (1.8), = 0.032], lower Albumin-to-Creatinine Ratio [72.60 (1008.30) vs. 342.30 (1172.1), = 0.039] and Hemoglobin levels [11.45 (1.8) vs. 12.60 (2.40), = 0.003], and higher levels of C-reactive protein [0.2 (0.80) vs. 0.03 (0.3), = 0.045] compared to non-sarcopenic. Under Poisson Multivariate Model, PhA [Relative precision (RP): 0.364, Confidence Interval (CI) (95%):0.259-0.511, < 0.001], Interleukin six (IL-6) [RP: 1.006, CI (95%):1.001-1.01, = 0.02] and serum creatinine levels [RP: 0.788, CI (95%): 0.641-0.969, = 0.024] were associated with sarcopenia.

Conclusions: Sarcopenia predominance was identified in our ND-CKD population, and was associated with lower PhA values, higher IL-6 levels, and lower serum creatinine levels.