Abstract: PUB371
Dynapenia, Muscle Mass, and Fracture Risk in CKD (Stages 1-5 ND)
Session Information
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Cigarran, Secundino, Hospital Da Costa, Vigo, GAL, Spain
- Monzón, Brandon, Hospital Da Costa, Burela, Lugo, Spain
- Sanjurjo amado, Ana maria, Sergas, Burela, Spain
- Menendez, Nicolas, Hospital Da Costa, Burela, Lugo, Spain
- De vicente, Manuel Pereira, Hospital Da Costa, Burela, Lugo, Spain
- Gonzalez tabares, Lourdes, Hospìtal Lucus Augusti, Lugo, Spain
- Latorre, Juan, Hospital Da Costa, Vigo, GAL, Spain
- Calvino, Jesus, Sergas, Burela, Spain
Background
Sarcopenia is highly prevalent in patients with Chronic Kidney Disease (CKD).Definition of Sarcopenia in the Elderly (EWGSOP 2018) includes low muscle mass associated to low muscle strength and/or low physical performance.In CKD, the relationship between protein synthesis and protein catabolism is altered producing an increase in the speed of skeletal muscle loss.The objective is to evaluate the influence of muscle mass and function with the risk of fracture, in patients with CKD 1-5 ND.
Methods
Cross-sectional study.880 patients were included.FRAX (Fracture Risk Assessment Tool) test was performed, considering the high risk of vertebral fracture at 10 years≥10% and hip at 10 years≥3%.Muscle mass was evaluated by vectorial BIA (BiaVector,Akern,Fl Ita).Strength was performed by handgrip(Akern,Fl,Ita) in Kg.Renal function was assessed by CKD-EPI and MDRD.
Results
Age 70.17±10.49 years, 60.7% women.Frequencies of CKD stage(S) were:S1 6.1%,S2 18%;S3 56.1%;S4 15.6% and S5 4.2%.Pts with dynapenia were significantly older.The glomerular filtration rate and the risk of osteoporotic fracture were significantly higher in the dynapenic subjects (p ≤0.05).However, the risk of hip fracture was only significant in the dynapenic women (Table).Interstitial fluid measured did not show statistical significance.
Conclusion
Dynapenia is a related risk of vertebral fractures in both sexes.Hip fracture risk is higher in women.In both cases muscle mass is normal.The promotion of physical exercise in order to: increase the traction on the bone, stimuli the muscle and increase the bone structure is relevant in these patients.Dynamometry evaluation should be included as a routine tool in clinical practice
Descriptive & ANOVA ( n=880)
| Variable | Women ≤ 16Kg | Women>16 Kg | Men ≤27 Kg | Men > 27 Kg | Total |
| Age (yr) | 75.60±9.25* | 69.64±10.71* | 75.01±9.07* | 67.17±9.95* | 70.20±10.49 |
| GFR-EPI (ml/min/1.73m2) | 41.92±18.04 | 47.92±23.66 | 42.90±18.74* | 48.71±21.62* | 46.68±21.48 |
| FRAX Osteoporosis % | 17.81±10.90* | 13.40±9.75* | 7.06±4.48* | 5.18±3.34* | 9.23±8.33 |
| FRAX hip fracture % | 8.84±8.15* | 6.14±7.88* | 3.57±2.91 | 2.23±2.53 | 4.30±5.84 |
| Mortality risk at 5 yr | 49.12±28.43* | 37.60±26.11* | 60.70±28.20* | 50.85±26.60* | 48.99±28.15 |
| BMI (Kg/m2) | 32.47±5.59 | 32.15±5.99 | 29.35±4.14 | 30.53±4.65 | 31.00±5.19 |
| Fat % | 43.54±8.00 | 42.07±6.97 | 32.90±6.32 | 32.53±6.50 | 36.49±8.33 |
| Muscle Mass % | 34.68±7.43* | 37.13±7.19* | 40.22±7.38* | 42.38±7.45* | 39.66±7.88 |
| Muscle Mass Kg | 25.32±5.42* | 28.03+5.85* | 31.47±6.81* | 36.34±7.11* | 31.93±7.78 |
| BMD by BIA (Gr/cm2)) | 0.87±0.08 | 0.97+0.17 | 0.92±0.07* | 1.04±0.24* | 0.98±0.19 |
Date are mean(SD)
Funding
- Other NIH Support