Kidney Week

Abstract: TH-PO919

Association of CKD with Sarcopenia: A Population-Wide Study

Session Information

• Geriatric Nephrology: Innovations and Insights
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1300 Geriatric Nephrology

Authors

• Alexiuk, Mackenzie R., University of Manitoba Department of Community Health Sciences, Winnipeg, Manitoba, Canada

Mackenzie R. Alexiuk, MSc

• Leon Mantilla, Silvia Juliana, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada

Silvia Juliana Leon Mantilla, MD, MS, MSc

• Hildebrand, Hailey Victoria, University of Manitoba Department of Internal Medicine, Winnipeg, Manitoba, Canada

Hailey Victoria Hildebrand, MD

• Bohm, Clara, University of Manitoba Department of Internal Medicine, Winnipeg, Manitoba, Canada

Clara Bohm, MD, MPH

• Leslie, William, University of Manitoba Department of Internal Medicine, Winnipeg, Manitoba, Canada

William Leslie, MD, MSc

• Tangri, Navdeep, University of Manitoba Department of Internal Medicine, Winnipeg, Manitoba, Canada

Navdeep Tangri, MD, PhD

Background

Sarcopenia, defined as the loss of muscle mass, is a growing public health concern and is an underrecognized problem in adults with Chronic Kidney Disease (CKD). The diagnosis of sarcopenia can be made via measurement of appendicular lean mass index (ALMi, indexed to height by m²), traditionally obtained through whole-body dual-energy X-ray absorptiometry (DXA) scans, however these are not frequently performed. As a result, large population-based studies examining the relationship between CKD and sarcopenia are lacking.

Methods

Using Manitoba longitudinal administrative health data, we identified adults who had at least one DXA scan linkable to serum creatinine values within 365 days, between 2007 and 2022. Serum creatinine was used to calculate estimated glomerular filtration rate, and estimated ALMi (eALMi) was calculated through central DXA scans via a previously developed algorithm. Linear, logistic, and Cox proportional hazards models were executed to examine the relationship between CKD, sarcopenia, and adverse clinical outcomes.

Results

Our cohort contained 24,660 individuals (64.4 ± 12.5 years, 84.4% female), with 3,204 individuals (13.0%) having eALMi indicating sarcopenia. 22,648 individuals (91.8%) had eGFR > 60, and 2,012 (8.2%) had eGFR < 60. After adjustment for age, sex, estimated central mass index, and comorbid conditions, the presence of eGFR < 60 was associated with higher odds of sarcopenia (OR: 1.39; 95% CI: 1.16–1.67). In individuals with two DXA scans (n=2,985), eGFR < 60 at baseline was associated with a larger decline in eALMi compared to individuals with preserved eGFR (OR: 1.61; 95% CI: 1.05–2.45). Both sarcopenia and declining eALMi were also associated with adverse clinical outcomes including hospitalization and emergency room visits, home care use, long-term care use, and all-cause mortality.

Conclusion

Our results show that CKD is associated with sarcopenia and leads to more rapid declines in appendicular lean mass over time. These findings further validate our central DXA based measurement of eALMi and sarcopenia and highlight the importance preservation of muscle mass in individuals with CKD, especially in those with reduced eGFR.

Funding

• Government Support – Non-U.S.