CORRELATION OF SARCOPENIA WITH DIABETES IN CKD V PRE DIALYSIS
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Keywords
Sarcopenia, Diabetes, CKD Stage V, Handgrip Strength, Arteriovenous Fistula
Abstract
Introduction: Sarcopenia, which refers to the loss of both muscle mass and strength, is present among CKD stage V pre-dialysis patients, especially those with diabetes, and results in worse prognoses.
Objective: The purpose of the present study was also to determine the prevalence of sarcopenia and its relation to diabetes in CKD stage V pre-dialysis patients and the effect on muscular strength.
Materials and Method: This quasi-experimental study was conducted at Ali Fatima Hospital, Bhobatian Chowk, Raiwind Road, Lahore, Pakistan, from October, 2023 to March, 2024, and included 90 patients with CKD stage V with eGFR<15 ml/min/1.73m². The dynamometer assessed handgrip strength at baseline and before 3 months of the creation of arteriovenous fistula (AVF). Diabetes mellitus was diagnosed with the help of medical records.
Results: Mean handgrip strength also reduced from 21.00 ± 7.35 kg to 19.22 ± 7.92 kg post-AVF (p<0.001). Handgrip strength was significantly lower in diabetic patients than in non-diabetic patients, 18. 45 ± 7.61 kg for people with diabetes, while for non-diabetics, it was 20.07 ± 8.23 kg (p=0.042). Diabetic patients who exhibited handgrip strength of less than 20 kg was 68.1% while that of non-diabetic patients was 51.2% (p=0.039).
Conclusion: Diabetes was found to harm sarcopenia in pre-dialysis CKD stage V patients, and there is a need to develop interventions.
References
2. Yu, M.D., Zhang, H.Z., Zhang, Y., Yang, S.P., Lin, M., Zhang, Y.M., Wu, J.B., Hong, F.Y. and Chen, W.X., 2021. Relationship between chronic kidney disease and sarcopenia. Scientific reports, 11(1), p.20523.
3. Huang, Y.F., Liu, S.P., Muo, C.H., Lai, C.Y. and Chang, C.T., 2024. Male sex and ageing are independent risk factors for Sarcopenia Stage in patients with chronic kidney Disease not yet on Dialysis. Journal of Cachexia, Sarcopenia and Muscle, 15(6), pp.2684-2692.
4. Oliveira, D., de Souza, V.A., Souza, G.C., Suassuna, L.F., Bastos, M.G., Reboredo, M.M. and da Silva Fernandes, N.M., 2025. Sarcopenic obesity in predialysis chronic kidney disease: Muscle strength is a predictor of mortlity and disease progression in a six-year prospective cohort. PloS one, 20(3), p.e0318773.
5. De Amorim, G.J., Calado, C.K.M., Souza de Oliveira, B.C., Araujo, R.P.O., Filgueira, T.O., de Sousa Fernandes, M.S., Castoldi, A., Vajgel, G., Valente, L.M., de Lima-Filho, J.L. and Carvalho, P.R.C., 2022. Sarcopenia in non-dialysis chronic kidney disease patients: Prevalence and associated factors. Frontiers in Medicine, 9, p.854410.
6. Zhou, C., Lin, X., Ma, G., Yuan, J. and Zha, Y., 2023. Increased predialysis extracellular to intracellular water ratio is associated with sarcopenia in hemodialysis patients. Journal of Renal Nutrition, 33(1), pp.157-164.
7. Ribeiro, H.S., Neri, S.G., Oliveira, J.S., Bennett, P.N., Viana, J.L. and Lima, R.M., 2022. Association between sarcopenia and clinical outcomes in chronic kidney disease patients: a systematic review and meta-analysis. Clinical Nutrition, 41(5), pp.1131-1140.
8. Isaka, Y., 2021. Optimal protein intake in pre-dialysis chronic kidney disease patients with sarcopenia: An overview. Nutrients, 13(4), p.1205.
9. Umakanthan, M., Li, J.W., Sud, K., Duque, G., Guilfoyle, D., Cho, K., Brown, C., Boersma, D. and Gangadharan Komala, M., 2021. Prevalence and factors associated with sarcopenia in patients on maintenance dialysis in Australia—a single centre, cross-sectional study. Nutrients, 13(9), p.3284.
10. Markaki, A., Kyriazis, P., Dermitzaki, E.K., Maragou, S., Psylinakis, E., Spyridaki, A., Drosataki, H., Lygerou, D., Grammatikopoulou, M.G., Petrakis, I. and Stylianou, K., 2021. The association between handgrip strength and predialysis serum sodium level in patients with chronic kidney disease stage 5D. Frontiers in Medicine, 7, p.610659.
11. Elder, M., Moonen, A., Crowther, S., Aleksova, J., Center, J. and Elder, G.J., 2023. Chronic kidney disease-related sarcopenia as a prognostic indicator in elderly haemodialysis patients. BMC nephrology, 24(1), p.138.
12. Do, J.Y., Kim, A.Y. and Kang, S.H., 2021. Association between phase angle and sarcopenia in patients undergoing peritoneal dialysis. Frontiers in Nutrition, 8, p.742081.
13. Shu, X., Lin, T., Wang, H., Zhao, Y., Jiang, T., Peng, X. and Yue, J., 2022. Diagnosis, prevalence, and mortality of sarcopenia in dialysis patients: a systematic review and meta‐analysis. Journal of cachexia, sarcopenia and muscle, 13(1), pp.145-158.
14. Silva, M.Z.C., Antonio, K.J., Reis, J.M.S., Alves, L.S., Caramori, J.C.T. and Vogt, B.P., 2021. Age, diabetes mellitus, and dialysis modality are associated with risk of poor muscle strength and physical function in hemodialysis and peritoneal dialysis patients. Kidney research and clinical practice, 40(2), p.294.
15. An, J.N., Kim, J.K., Lee, H.S., Kim, S.G., Kim, H.J. and Song, Y.R., 2021. Late stage 3 chronic kidney disease is an independent risk factor for sarcopenia, but not proteinuria. Scientific Reports, 11(1), p.18472.
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Dr. Hafiz Faisal Munir Qamar
Registrar Nephrology, Ali Fatima Hospital, Bhobatian Chowk, Raiwind Road, Lahore, Pakistan
Dr. Muhammad Mohsin Riaz
Assistant Professor of Nephrology, Ali Fatima Hospital, Bhobatian Chowk, Raiwind Road, Lahore, Pakistan
Dr. Mubashir Dilawar
Registrar Nephrology, Fatima Memorial Hospital, Lahore, Pakistan
Dr. Aqeel Ahmed
Senior Registrar Nephrology, Gujranwala Medical College Teaching Hospital, Gujranwala, Pakistan
Dr. Nabiha Rizvi
Assistant Professor of Nephrology, Lahore Medical and Dental College Lahore, Pakistan
Dr. Muhammad Asif
Senior Registrar Nephrology, DG Khan Medical College Dera Ghazi Khan, Pakistan
Dr. Hafiz Nauman Munir Saqib
Medical Officer of Nephrology, Evercare Hospital, Lahore, Pakistan