Abstract: TH-PO928
Do Protein Intake, Serum Bicarbonate, and Inflammatory Markers Explain the Associations of Advanced CKD with Muscle Wasting?
Session Information
- Health Maintenance, Nutrition, Metabolism - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Akrami, Farahnaz, University of Utah Health, Salt Lake City, Utah, United States
- Singh, Ravinder, University of Utah Health, Salt Lake City, Utah, United States
- Boucher, Robert E., University of Utah Health, Salt Lake City, Utah, United States
- Wei, Guo, University of Utah Health, Salt Lake City, Utah, United States
- Takyi, Augustine, University of Utah Health, Salt Lake City, Utah, United States
- Mohammed, Azeem Mohiuddin, University of Utah Health, Salt Lake City, Utah, United States
- Sarwal, Amara, University of Utah Health, Salt Lake City, Utah, United States
- Hartsell, Sydney Elizabeth, University of Utah Health, Salt Lake City, Utah, United States
- Bissada, George, University of Utah Health, Salt Lake City, Utah, United States
- Beddhu, Srinivasan, University of Utah Health, Salt Lake City, Utah, United States
Background
Muscle wasting is a significant concern in individuals with chronic kidney disease (CKD) as it adversely affects their overall well-being and increases the risk of mortality. Low protein intake, metabolic acidosis and systemic inflammation are considered to be some of the main drivers of muscle wasting in CKD. Therefore, we examined in the Chronic Renal Insufficiency Cohort (CRIC), whether these factors explain muscle wasting in CKD.
Methods
We included 3040 eligible CRIC participants. Baseline protein intake was determined from dietary protein intake. Serum bicarbonate was used as marker of acid-base status. Serum hsCRP, IL6, fibrinogen, TNFa and IL1beta were used to derive a previously published CRIC inflammatory score. Muscle wasting was defined as gender specific lowest quartile of fat-free mass estimated from bioelectrical impedance analysis (BIA) at month 24 visit . We investigated the association between low fat-free mass (FFM) and eGFR groups using logistic regression, with covariate adjustment for age, gender, race, site, comorbidities, SBP, DBP, and medications. With additional adjustment for baseline protein intake, serum bicarbonate, and inflammatory score, we examined whether the associations of CKD stages with low FFM at month 24 were attenuated.
Results
Mean baseline age was 58 ± 11 years, 56% were male, 40% were black, and mean eGFR was 45 ± 15. Mean weight was 91 ± 23 kg and mean FFM was 61 ± 16 kg. n multivariate logistic regression model, more advanced CKD was associated with significantly higher risk of low FFM (Figure 1 Panel A). These associations persisted after adjusting for baseline protein intake, serum bicarbonate, and inflammatory score (Figure 1 Panel B).
Conclusion
More advanced CKD is strong predictor of muscle wasting. These associations are not fully explained by protein intake, serum bicarbonate and inflammatory markers. Further studies are needed to unravel the mechanisms of muscle wasting in CKD.
Funding
- NIDDK Support