Skip to main content

Advertisement

SpringerLink
Log in

Could sarcopenia-related mortality in end-stage renal disease be underpinned by the number of hospitalizations and cardiovascular diseases?

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the association between sarcopenia with the number of all-cause mortality, hospitalizations, and cardiovascular diseases in patients with end-stage renal disease (ESRD).

Methods

247 patients with ESRD (women, n = 97) (66.6 ± 3.53 years) participated in this study. At baseline, all participants were measured with dual-energy X-ray absorptiometry and handgrip dynamometer and were prospectively followed up for 5 years. The European Working Group on Sarcopenia in Older People guidelines were utilized for Sarcopenia determination. Cox proportional hazard analysis adjusted for established risk factors was used to quantify the risk between Sarcopenia and all-cause mortality.

Results

Sixty-five participants (26%) were determined to have Sarcopenia at baseline and 38 (15%) have died during the follow-up. At baseline, Participants with Sarcopenia had lower body mass index and fat-free mass index. Moreover, through the 5-year follow-up, sarcopenic patients had higher number of cardiovascular disease (56.9% vs. 12.6%) and hospitalizations (93.8% vs. 49.5%) (all P < 0.0001). Sarcopenia was associated with significantly higher risk of mortality, [Hazard ratio = 3.3, (95% CI: 1.6–6.9), P = 0.001].

Conclusion

Sarcopenia may be a risk factor for hospitalizations, cardiovascular diseases, and all-cause mortality in patients with ESRD. These results provide support of the relevance in assessing sarcopenia in the clinical practice of chronic kidney disease and how muscle mass and strength may negatively impact the daily life of ESRD patients undergoing hemodialysis. Greater efforts at preventing muscle wasting and malfunctioning are needed through the worldwide healthcare system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Romagnani P, Remuzzi G, Glassock R, Levin A, Jager KJ, Tonelli M et al (2017) Chronic kidney disease. Nat Rev Dis Primers 3:17088

    Article  Google Scholar 

  2. Androga L, Sharma D, Amodu A, Abramowitz MK (2017) Sarcopenia, obesity, and mortality in US adults with and without chronic kidney disease. Kidney Int Rep 2(2):201–211

    Article  Google Scholar 

  3. Kim JK, Kim SG, Oh JE, Lee YK, Noh JW, Kim HJ et al (2019) Impact of sarcopenia on long-term mortality and cardiovascular events in patients undergoing hemodialysis. Korean J Intern Med 34(3):599–607

    Article  CAS  Google Scholar 

  4. Pereira RA, Cordeiro AC, Avesani CM, Carrero JJ, Lindholm B, Amparo FC et al (2015) Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality. Nephrol Dial Transplant 30(10):1718–1725

    Article  CAS  Google Scholar 

  5. Ren H, Gong D, Jia F, Xu B, Liu Z (2016) Sarcopenia in patients undergoing maintenance hemodialysis: incidence rate, risk factors and its effect on survival risk. Ren Fail 38(3):364–371

    Article  CAS  Google Scholar 

  6. Wilkinson TJ, Miksza J, Yates T, Lightfoot CJ, Baker LA, Watson EL et al (2021) Association of sarcopenia with mortality and end-stage renal disease in those with chronic kidney disease: a UK Biobank study. J Cachexia Sarcopenia Muscle 12(3):586–598

    Article  Google Scholar 

  7. Ziolkowski SL, Long J, Baker JF, Chertow GM, Leonard MB (2019) Relative sarcopenia and mortality and the modifying effects of chronic kidney disease and adiposity. J Cachexia Sarcopenia Muscle 10(2):338–346

    Article  Google Scholar 

  8. Watanabe H, Enoki Y, Maruyama T (2019) Sarcopenia in chronic kidney disease: factors, mechanisms, and therapeutic interventions. Biol Pharm Bull 42(9):1437–1445

    Article  CAS  Google Scholar 

  9. Bauer J, Morley JE, Schols A, Ferrucci L, Cruz-Jentoft AJ, Dent E et al (2019) Sarcopenia: a time for action. An SCWD position paper. J Cachexia Sarcopenia Muscle 10(5):956–961

    Article  Google Scholar 

  10. Kallenberg MH, Kleinveld HA, Dekker FW, van Munster BC, Rabelink TJ, van Buren M et al (2016) Functional and cognitive impairment, frailty, and adverse health outcomes in older patients reaching ESRD-a systematic review. Clin J Am Soc Nephrol CJASN 11(9):1624–1639

    Article  Google Scholar 

  11. Fitzpatrick J, Sozio SM, Jaar BG, Estrella MM, Segev DL, Parekh RS et al (2019) Frailty, body composition and the risk of mortality in incident hemodialysis patients: the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease study. Nephrol Dial Transplant 34(2):346–354

    Article  CAS  Google Scholar 

  12. Yang M, Liu Y, Zuo Y, Tang H (2019) Sarcopenia for predicting falls and hospitalization in community-dwelling older adults: EWGSOP versus EWGSOP2. Sci Rep 9(1):17636

    Article  Google Scholar 

  13. Giglio J, Kamimura MA, Lamarca F, Rodrigues J, Santin F, Avesani CM (2018) Association of sarcopenia with nutritional parameters, quality of life, hospitalization, and mortality rates of elderly patients on hemodialysis. J Renal Nutr 28(3):197–207

    Article  Google Scholar 

  14. Hirai K, Ookawara S, Morishita Y (2016) Sarcopenia and physical inactivity in patients with chronic kidney disease. Nephro-urology Monthly 8(3):e37443

    Article  Google Scholar 

  15. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39(4):412–423

    Article  Google Scholar 

  16. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(1):16–31

    Article  Google Scholar 

  17. Kittiskulnam P, Chertow GM, Carrero JJ, Delgado C, Kaysen GA, Johansen KL (2017) Sarcopenia and its individual criteria are associated, in part, with mortality among patients on hemodialysis. Kidney Int 92(1):238–247

    Article  Google Scholar 

  18. Silva PAB, Silva LB, Santos JFG, Soares SM (2020) Brazilian public policy for chronic kidney disease prevention: challenges and perspectives. Rev Saude Publica 54:86

    Article  Google Scholar 

  19. Brown JH, Hunt LP, Vites NP, Short CD, Gokal R, Mallick NP (1994) Comparative mortality from cardiovascular disease in patients with chronic renal failure. Nephrol Dial Transplant 9(8):1136–1142

    Article  CAS  Google Scholar 

  20. Schrauben SJ, Chen HY, Lin E, Jepson C, Yang W, Scialla JJ et al (2020) Hospitalizations among adults with chronic kidney disease in the United States: a cohort study. PLoS Med 17(12):e1003470

    Article  Google Scholar 

  21. Corrêa HL, Rosa TDS, Dutra MT, Sales MM, Noll M, Deus LA et al (2021) Association between dynapenic abdominal obesity and inflammatory profile in diabetic older community-dwelling patients with end-stage renal disease. Exp Gerontol 146:111243

    Article  Google Scholar 

  22. Gadelha AB, Cesari M, Corrêa HL, Neves RVP, Sousa CV, Deus LA et al (2021) Effects of pre-dialysis resistance training on sarcopenia, inflammatory profile, and anemia biomarkers in older community-dwelling patients with chronic kidney disease: a randomized controlled trial. Int Urol Nephrol 53:2137

    Article  CAS  Google Scholar 

  23. Neves RVP, Corrêa HL, Deus LA, Reis AL, Souza MK, Simões HG et al (2021) Dynamic not isometric training blunts osteo-renal disease and improves the sclerostin/FGF23/Klotho axis in maintenance hemodialysis patients: a randomized clinical trial. J Appl Physiol 130(2):508–516

    Article  CAS  Google Scholar 

  24. Mathiowetz V, Weber K, Volland G, Kashman N (1984) Reliability and validity of grip and pinch strength evaluations. J Hand Surg 9(2):222–226

    Article  CAS  Google Scholar 

  25. Gadelha AB, Neri SGR, Oliveira RJ, Bottaro M, David AC, Vainshelboim B et al (2018) Severity of sarcopenia is associated with postural balance and risk of falls in community-dwelling older women. Exp Aging Res 44(3):258–269

    Article  Google Scholar 

  26. Gadelha AB, Vainshelboim B, Ferreira AP, Neri SGR, Bottaro M, Lima RM (2018) Stages of sarcopenia and the incidence of falls in older women: a prospective study. Arch Gerontol Geriatr 79:151–157

    Article  Google Scholar 

  27. Petermann-Rocha F, Balntzi V, Gray SR, Lara J, Ho FK, Pell JP et al (2022) Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 13(1):86–99

    Article  Google Scholar 

  28. Isoyama N, Qureshi AR, Avesani CM, Lindholm B, Bàràny P, Heimbürger O et al (2014) Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. Clin J Am Soc Nephrol CJASN 9(10):1720–1728

    Article  Google Scholar 

  29. Mori K, Nishide K, Okuno S, Shoji T, Emoto M, Tsuda A et al (2019) Impact of diabetes on sarcopenia and mortality in patients undergoing hemodialysis. BMC Nephrol 20(1):105

    Article  Google Scholar 

  30. Alcalde PR, Kirsztajn GM (2018) Gastos do Sistema Único de Saúde brasileiro com doença renal crônica. Braz J Nephrol 40:122–129

    Article  Google Scholar 

  31. Jones G, Trajanoska K, Santanasto AJ, Stringa N, Kuo CL, Atkins JL et al (2021) Genome-wide meta-analysis of muscle weakness identifies 15 susceptibility loci in older men and women. Nat Commun 12(1):654

    Article  CAS  Google Scholar 

  32. Arthur ST, Cooley ID (2012) The effect of physiological stimuli on sarcopenia; impact of Notch and Wnt signaling on impaired aged skeletal muscle repair. Int J Biol Sci 8(5):731–760

    Article  Google Scholar 

  33. Jang YC, Sinha M, Cerletti M, Dall’Osso C, Wagers AJ (2011) Skeletal muscle stem cells: effects of aging and metabolism on muscle regenerative function. Cold Spring Harb Symp Quant Biol 76:101–111

    Article  CAS  Google Scholar 

  34. Renault V, Thornell LE, Eriksson PO, Butler-Browne G, Mouly V (2002) Regenerative potential of human skeletal muscle during aging. Aging Cell 1(2):132–139

    Article  CAS  Google Scholar 

  35. Sousa-Victor P, Gutarra S, García-Prat L, Rodriguez-Ubreva J, Ortet L, Ruiz-Bonilla V et al (2014) Geriatric muscle stem cells switch reversible quiescence into senescence. Nature 506(7488):316–321

    Article  CAS  Google Scholar 

  36. Sabatino A, Cuppari L, Stenvinkel P, Lindholm B, Avesani CM (2021) Sarcopenia in chronic kidney disease: what have we learned so far? J Nephrol 34(4):1347–1372

    Article  Google Scholar 

  37. Vasankari V, Husu P, Vähä-Ypyä H, Suni J, Tokola K, Halonen J et al (2017) Association of objectively measured sedentary behaviour and physical activity with cardiovascular disease risk. Eur J Prev Cardiol 24(12):1311–1318

    Article  Google Scholar 

  38. Johansen KL, Lee C (2015) Body composition in chronic kidney disease. Curr Opin Nephrol Hypertens 24(3):268–275

    CAS  Google Scholar 

  39. Kalantar-Zadeh K, Abbott KC, Salahudeen AK, Kilpatrick RD, Horwich TB (2005) Survival advantages of obesity in dialysis patients. Am J Clin Nutr 81(3):543–554

    Article  CAS  Google Scholar 

  40. Park J, Ahmadi SF, Streja E, Molnar MZ, Flegal KM, Gillen D et al (2014) Obesity paradox in end-stage kidney disease patients. Prog Cardiovasc Dis 56(4):415–425

    Article  Google Scholar 

  41. Meeuwsen S, Horgan GW, Elia M (2010) The relationship between BMI and percent body fat, measured by bioelectrical impedance, in a large adult sample is curvilinear and influenced by age and sex. Clin Nutr (Edinburgh, Scotland) 29(5):560–566

    Article  CAS  Google Scholar 

Download references

Funding

This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, (Grand 001, 001, 001).

Author information

Authors and Affiliations

  1. Graduate Program of Physical Education, Catholic University of Brasilia, UCB, EPTC, QS07, LT1 s/n. Bloco G Sala 119, Águas Claras, Taguatinga, Brasília, DF, 72030-170, Brazil

    Hugo de Luca Corrêa, Lysleine Alves Deus, Rodrigo Vanerson Passos Neves, Andrea Lucena Reis, Thaís Branquinho de Araújo & Thiago dos Santos Rosa

  2. Serviço de Preparação Física/COSAU/DIGEP/SA/SG/Presidência da República, Zona Cívico-Administrativa, Brasília, DF, 70150-900, Brazil

    André Bonadias Gadelha

  3. Cardiovascular and Metabolic Disease Research Institute, Mountain View, CA, USA

    Baruch Vainshelboim

  4. Federal Institute of Education, Science and Technology of Brasilia, College of Physical Education, Brasília, Brazil

    Maurílio Tiradentes Dutra

  5. College of Physical Education, University of Brasília, Brasília, DF, Brazil

    Maurílio Tiradentes Dutra

  6. Federal Institute of Sudeste of Minas Gerais, Campus Rio Pomba, Rio Pomba, MG, Brazil

    João B. Ferreira-Júnior

  7. HDC RenalClass, São Paulo, Brazil

    Carmen Tzanno-Martins

  8. Department of Medicine, Catholic University of Brasilia, Brasília, DF, Brazil

    Fernanda Silveira Tavares

  9. Graduate Program of Genomic Sciences and Biotechnology, Catholic University of Brasilia, Brasília, DF, Brazil

    Rosângela Vieira Andrade

  10. Seção de Educação Física, Colégio Militar de Brasília, Asa Norte, Brasília, DF, Brasil

    André Bonadias Gadelha

Authors
  1. Hugo de Luca Corrêa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. André Bonadias Gadelha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Baruch Vainshelboim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maurílio Tiradentes Dutra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. João B. Ferreira-Júnior
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lysleine Alves Deus
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rodrigo Vanerson Passos Neves
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Andrea Lucena Reis
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Thaís Branquinho de Araújo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Carmen Tzanno-Martins
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Fernanda Silveira Tavares
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Rosângela Vieira Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Thiago dos Santos Rosa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hugo de Luca Corrêa.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Luca Corrêa, H., Gadelha, A.B., Vainshelboim, B. et al. Could sarcopenia-related mortality in end-stage renal disease be underpinned by the number of hospitalizations and cardiovascular diseases?. Int Urol Nephrol 55, 157–163 (2023). https://doi.org/10.1007/s11255-022-03291-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-022-03291-5

Keywords

Search

Navigation