Abstract
Cardiovascular disease (CVD) incidence is high in patients with chronic kidney disease (CKD) and is the most frequent cause of mortality in this population. Advanced age, hypertension, uremic toxins, endothelial dysfunction, atherosclerosis, hyperhomocysteinemia, oxidative stress, and inflammation are among the leading causes of increased CVD in advanced stages of CKD. Although defined as a decrease in muscle strength associated with aging, sarcopenia is also prevalent in CKD patients. Sarcopenia causes physical disability, low quality of life, and mortality. Regular exercise and nutritional supplementation may slow the progression of sarcopenia. Recent studies have shown that sarcopenia increases the risk of CVD and mortality in people with or without kidney disease. This review discusses the relationship between sarcopenia and CVD in light of the current literature.
Similar content being viewed by others
References
Rosenberg IH (1997) Sarcopenia: origins and clinical relevance. J Nutr 127(5 Suppl):990S-S991
Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(1):16–31
Carvalho do Nascimento PR, Poitras S, Bilodeau M (2018) How do we define and measure sarcopenia? Protocol for a systematic review. Syst Rev 7(1):51
Castillo-Olea C, Garcia-Zapirain Soto B, Carballo Lozano C, Zuniga C (2019) Automatic classification of sarcopenia level in older adults: a case study at Tijuana General Hospital. Int J Environ Res Public Health 16(18):1
Kim H, Hirano H, Edahiro A et al (2016) Sarcopenia: prevalence and associated factors based on different suggested definitions in community-dwelling older adults. Geriatr Gerontol Int 16(Suppl 1):110–122
Chatzipetrou V, Bégin MJ, Hars M, Trombetti A (2022) Sarcopenia in chronic kidney disease: a scoping review of prevalence, risk factors, association with outcomes, and treatment. Calcif Tissue Int 110(1):1–31
Bataille S, Chauveau P, Fouque D, Aparicio M, Koppe L (2021) Myostatin and muscle atrophy during chronic kidney disease. Nephrol Dial Transplant 36(11):1986–1993
Mattera MVN, Aucella F, Tegola LL, Testini V, De Guio F, Guglielmi G (2021) Prevalence and risk factors for sarcopenia in chronic kidney disease patients undergoing dialysis: a cross-sectional study. Turk J Nephrol 30:294–299
Ribeiro HS, Neri SGR, Oliveira JS, Bennett PN, Viana JL, Lima RM (2022) Association between sarcopenia and clinical outcomes in chronic kidney disease patients: a systematic review and meta-analysis. Clin Nutr 41(5):1131-1140.10
Shu X, Lin T, Wang H, Zhao Y, Jiang T, Peng X, Yue J (2022) Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 13(1):145–158
Jankowski J, Floege J, Fliser D, Bohm M, Marx N (2021) Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options. Circulation 143(11):1157–1172
Im IJ, Choi HJ, Jeong SM, Kim HJ, Son JS, Oh HJ (2017) The association between muscle mass deficits and arterial stiffness in middle-aged men. Nutr Metab Cardiovasc Dis 27(12):1130–1135
Curcio F, Testa G, Liguori I et al (2020) Sarcopenia and heart failure. Nutrients 12(1):1
Coats AJ, Clark AL, Piepoli M, Volterrani M, Poole-Wilson PA (1994) Symptoms and quality of life in heart failure: the muscle hypothesis. Br Heart J 72(2 Suppl):S36–S39
Ohara M, Kohara K, Tabara Y et al (2014) Sarcopenic obesity and arterial stiffness, pressure wave reflection and central pulse pressure: the J-SHIPP study. Int J Cardiol 174(1):214–217
Veijalainen A, Tompuri T, Haapala EA et al (2016) Associations of cardiorespiratory fitness, physical activity, and adiposity with arterial stiffness in children. Scand J Med Sci Sports 26(8):943–950
Lee D, Byun K, Hwang M-H, Lee S (2021) Augmentation index is inversely associated with skeletal muscle mass, muscle strength, and anaerobic power in young male adults: a preliminary study. Appl Sci 11(7):3146
Tap L, Kirkham FA, Mattace-Raso F, Joly L, Rajkumar C, Benetos A (2020) Unraveling the links underlying arterial stiffness, bone demineralization, and muscle loss. Hypertension 76(3):629–639
Ochi M, Kohara K, Tabara Y et al (2010) Arterial stiffness is associated with low thigh muscle mass in middle-aged to elderly men. Atherosclerosis 212(1):327–332
Cleasby ME, Jamieson PM, Atherton PJ (2016) Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J Endocrinol 229(2):R67-81
Timmerman KL, Volpi E (2013) Endothelial function and the regulation of muscle protein anabolism in older adults. Nutr Metab Cardiovasc Dis 23(Suppl 1):S44-50
Xue Q, Wu J, Ren Y, Hu J, Yang K, Cao J (2021) Sarcopenia predicts adverse outcomes in an elderly population with coronary artery disease: a systematic review and meta-analysis. BMC Geriatr 21(1):493
Jun JE, Choi MS, Park SW et al (2021) Low skeletal muscle mass is associated with the presence, incidence, and progression of coronary artery calcification. Can J Cardiol 37(9):1480–1488
Xia MF, Chen LY, Wu L et al (2021) Sarcopenia, sarcopenic overweight/obesity and risk of cardiovascular disease and cardiac arrhythmia: a cross-sectional study. Clin Nutr 40(2):571–580
Bellanti F, Romano AD, Lo Buglio A et al (2018) Oxidative stress is increased in sarcopenia and associated with cardiovascular disease risk in sarcopenic obesity. Maturitas 109:6–12
Han E, Lee YH, Kim YD et al (2020) Nonalcoholic fatty liver disease and sarcopenia are independently associated with cardiovascular risk. Am J Gastroenterol 115(4):584–595
Ahisar Y, Thanassoulis G, Huang KN, Ohayon SM, Afilalo J (2021) Intersecting genetics of frailty and cardiovascular disease. J Nutr Health Aging 25(8):1023–1027
Uchida S, Kamiya K, Hamazaki N et al (2020) Association between sarcopenia and atherosclerosis in elderly patients with ischemic heart disease. Heart Vessels 35(6):769–775
Han P, Chen X, Yu X et al (2020) The predictive value of sarcopenia and its individual criteria for cardiovascular and all-cause mortality in suburb-dwelling older Chinese. J Nutr Health Aging 24(7):765–771
Wu Y, Wang W, Liu T, Zhang D (2017) Association of grip strength with risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations: a meta-analysis of prospective cohort studies. J Am Med Dir Assoc 18(6):551 (e17–e35)
Leong DP, Teo KK, Rangarajan S et al (2015) Prognostic value of grip strength: findings from the prospective urban rural epidemiology (PURE) study. Lancet 386(9990):266–273
Gubelmann C, Vollenweider P, Marques-Vidal P (2017) No association between grip strength and cardiovascular risk: the CoLaus population-based study. Int J Cardiol 236:478–482
Brown JC, Harhay MO, Harhay MN (2016) Sarcopenia and mortality among a population-based sample of community-dwelling older adults. J Cachexia Sarcopenia Muscle 7(3):290–298
Pizzimenti M, Meyer A, Charles AL et al (2020) Sarcopenia and peripheral arterial disease: a systematic review. J Cachexia Sarcopenia Muscle 11(4):866–886
Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA (2014) BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr 99(4):875–890
Atkins JL, Wannamathee SG (2020) Sarcopenic obesity in ageing: cardiovascular outcomes and mortality. Br J Nutr 124(10):1102–1113
Farmer RE, Mathur R, Schmidt AF et al (2019) Associations between measures of sarcopenic obesity and risk of cardiovascular disease and mortality: a cohort study and mendelian randomization analysis using the UK Biobank. J Am Heart Assoc 8(13):e011638
Stephen WC, Janssen I (2009) Sarcopenic-obesity and cardiovascular disease risk in the elderly. J Nutr Health Aging 13(5):460–466
Cho HW, Chung W, Moon S, Ryu OH, Kim MK, Kang JG (2021) Effect of sarcopenia and body shape on cardiovascular disease according to obesity phenotypes. Diabetes Metab J 45(2):209–218
Bright R (1836) Cases and observations illustrative of renal disease accompanied with the secretion of albuminous urine. Guy’s Hosp Rep 10:338–340
Stevens P, O’donoghue D, De Lusignan S et al (2007) Chronic kidney disease management in the United Kingdom: NEOERICA project results. Kidney Int 72(1):92–9
Thompson S, James M, Wiebe N et al (2015) Cause of death in patients with reduced kidney function. J Am Soc Nephrol 26(10):2504–2511
Webster AC, Nagler EV, Morton RL, Masson P (2017) Chronic kidney disease. Lancet 389(10075):1238–1252
Barbalho SM, Flato UAP, Tofano RJ et al (2020) Physical exercise and myokines: relationships with sarcopenia and cardiovascular complications. Int J Mol Sci 21(10):3607
Hanatani S, Izumiya Y, Onoue Y et al (2018) Non-invasive testing for sarcopenia predicts future cardiovascular events in patients with chronic kidney disease. Int J Cardiol 268:216–221
Kosmadakis GC, Bevington A, Smith A et al (2010) Physical exercise in patients with severe kidney disease. Nephron Clin Pract 115(1):c7–c16
Morioka T (2020) Myostatin: the missing link between sarcopenia and cardiovascular disease in chronic kidney disease? J Atheroscler Thrombosis 27(10):1036–1038
Verzola D, Barisione C, Picciotto D, Garibotto G, Koppe L (2019) Emerging role of myostatin and its inhibition in the setting of chronic kidney disease. Kidney Int 95(3):506–517
Esposito P, Verzola D, Porta EL et al (2020) Myostatin in the arterial wall of patients with end-stage renal disease. J Atheroscler Thrombosis 27(10):1039–1052
Lee SM, Kim SE, Lee JY, Jeong HJ, Son YK, An WS (2019) Serum myostatin levels are associated with abdominal aortic calcification in dialysis patients. Kidney Res Clin Pract 38(4):481–489
Pedersen BK, Febbraio MA (2008) Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiol Rev 88(4):1379–1406
Honda H, Qureshi AR, Axelsson J et al (2007) Obese sarcopenia in patients with end-stage renal disease is associated with inflammation and increased mortality. Am J Clin Nutr 86(3):633–638
Gomes TS, Santo Silva DdE, Junior GFX, de Farias Costa PR, Sena MHLG, Medeiros JMB (2021) Sarcopenia and mortality in patients with chronic non-dialytic renal disease: systematic review and meta-analysis. J Renal Nutr 2021:1
Beddhu S, Pappas LM, Ramkumar N, Samore M (2003) Effects of body size and body composition on survival in hemodialysis patients. J Am Soc Nephrol 14(9):2366–2372
Kruse NT, Buzkova P, Barzilay JI et al (2020) Association of skeletal muscle mass, kidney disease and mortality in older men and women: the cardiovascular health study. Aging (Albany NY) 12(21):21023
Kato A, Ishida J, Endo Y et al (2011) Association of abdominal visceral adiposity and thigh sarcopenia with changes of arteriosclerosis in haemodialysis patients. Nephrol Dialysis Transpl 26(6):1967–1976
Lai S, Muscaritoli M, Andreozzi P et al (2019) Sarcopenia and cardiovascular risk indices in patients with chronic kidney disease on conservative and replacement therapy. Nutrition 62:108–114
Arnarson A, Geirsdottir OG, Ramel A, Briem K, Jonsson P, Thorsdottir I (2013) Effects of whey proteins and carbohydrates on the efficacy of resistance training in elderly people: double blind, randomised controlled trial. Eur J Clin Nutr 67(8):821–826
Yoo S-Z, No M-H, Heo J-W et al (2018) Role of exercise in age-related sarcopenia. J Exerc Rehabil 14(4):551
Kopple JD, Wang H, Casaburi R et al (2007) Exercise in maintenance hemodialysis patients induces transcriptional changes in genes favoring anabolic muscle. J Am Soc Nephrol 18(11):2975–2986
Hiroshige K, Sonta T, Suda T, Kanegae K, Ohtani A (2001) Oral supplementation of branched-chain amino acid improves nutritional status in elderly patients on chronic haemodialysis. Nephrol Dial Transpl 16(9):1856–1862
Eustace JA, Coresh J, Kutchey C et al (2000) Randomized double-blind trial of oral essential amino acids for dialysis-associated hypoalbuminemia. Kidney Int 57(6):2527–2538
Yano S, Nagai A, Isomura M et al (2015) Relationship between blood myostatin levels and kidney function: shimane CoHRE study. PLoS ONE 10(10):e0141035
Tamaki M, Miyashita K, Hagiwara A et al (2017) Ghrelin treatment improves physical decline in sarcopenia model mice through muscular enhancement and mitochondrial activation. Endocr J 64(Suppl.):S47–S51
Yu R, Chen Ja XuJ et al (2017) Suppression of muscle wasting by the plant-derived compound ursolic acid in a model of chronic kidney disease. J Cachexia Sarcopenia Muscle 8(2):327–341
Sabatino A, Cuppari L, Stenvinkel P, Lindholm B, Avesani CM (2020) Sarcopenia in chronic kidney disease: what have we learned so far? J Nephrol 2020:1–26
Barazzoni R, Zhu XX, DeBoer M, Datta R, Culler MD, Zanetti M, Guarnieri G, Marks DL (2010) Combined effects of ghrelin and higher food intake enhance skeletal muscle mitochondrial oxidative capacity and AKT phosphorylation in rats with chronic kidney disease. Kidney Int 77(1):23–28. https://doi.org/10.1038/ki.2009.411. ISSN 0085-2538
Smith GI, Atherton P, Reeds DN, Mohammed BS, Rankin D, Rennie MJ, Mittendorfer B (2011) Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: a randomized controlled trial. Am J Clin Nutr 93(2):402–412. https://doi.org/10.3945/ajcn.110.005611
Bauer JM, Verlaan S, Bautmans I, Brandt K, Donini LM, Maggio M, McMurdo MET, Mets T, Seal C, Wijers SL, Ceda GP, De Vito G, Donders G, Drey M, Greig C, Holmbäck U, Narici M, McPhee J, Poggiogalle E, Power D, Scafoglieri A, Schultz R, Sieber CC, Cederholm T (2015) Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Direc Assoc 16(9):740–747. https://doi.org/10.1016/j.jamda.2015.05.021. ISSN 1525-8610
Funding
No funding was received for the preparation of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Gungor, O., Sevinc, M., Ulu, S. et al. Sarcopenia and cardiovascular disease in patients with and without kidney disease: what do we know?. Int Urol Nephrol 55, 1161–1171 (2023). https://doi.org/10.1007/s11255-022-03393-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-022-03393-0