Kidney Week

Abstract: TH-PO163

Low Muscle Mass Is Associated with Low Bone Mineral Density in Patients with CKD Stages G4-5

Session Information

• CKD-MBD: Clinical
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

• 502 Bone and Mineral Metabolism: Clinical

Authors

• Rashid, Anahita, Department of Nephrology, Herlev and Gentofte, Herlev, Denmark

Anahita Rashid, MD

• Hauge, Sabina Chaudhary, Department of Nephrology, Herlev and Gentofte, Herlev, Denmark

Sabina Chaudhary Hauge, MD

• Nordholm, Anders, Department of Nephrology, Herlev and Gentofte, Herlev, Denmark

Anders Nordholm, MD, PhD

• Jørgensen, Anne Sofie Fredberg, Department of Nephrology, Odense University Hospital, Odense, Denmark

Anne Sofie Fredberg Jørgensen, MD

• Nagarajah, Subagini, Department of Nephrology, Odense University Hospital, Odense, Denmark

Subagini Nagarajah, MD, PhD

• Zerahn, Bo, Department of Nuclear Medicine, Herlev & Gentofte Hospital, Herlev, Denmark

Bo Zerahn, MD

• Suetta, Charlotte, Geriatric Research Unit, Department of Medicine, Herlev & Gentofte Hospital, Herlev, Denmark

Charlotte Suetta, MD, DrMed, PhD

• Frost, Morten, Department of Endocrinology, Odense University Hospital, Odense, Denmark

Morten Frost, MD

• Hansen, Ditte, Department of Nephrology, Herlev and Gentofte, Herlev, Denmark

Ditte Hansen, MD, PhD

Background

Patients with chronic kidney disease (CKD) experience a decrease in bone mineral density (BMD), which raises their risk of fractures. Preclinical studies have shown a cross-talk between bone and muscle, emphasizing the importance of investigating the relationship between muscle mass and BMD in patients with CKD. Sarcopenia a condition characterized by low muscle mass and strength is common in CKD. CKD-related sarcopenia is believed to develop more rapidly and occur earlier in adult life, further increasing the risk of fractures in patients. Therefore, this study aimed to explore the association between muscle mass and BMD in patients with CKD.

Methods

This cross-sectional study included patients with CKD G4-5. All patients were examined by whole-body dual-energy x-ray absorptiometry (DXA). BMD of the spine and hips were determined. The muscle mass was measured as the appendicular skeletal muscle mass (ASMM). Linear regression analysis was performed to explore the association between BMD and ASMM, and multivariate linear regression analysis was performed, adjusting for age, gender, body mass index (BMI), and level of 25-OH-Vitamin D.

Results

We included 140 patients; 66 (47%) were female with a mean age of 68 (SD 13) years and a mean eGFR of 18 (SD 7) ml/min/1.73m². Thirty-five patients (25%) had a BMD of <-2.5 standard deviations below peak bone mass in at least one site (T-score). The mean ASMM was 21 kg (SD 6). Thirty-six (26%) patients had an ASMM lower than the European Working Group on Sarcopenia in Older People cut-off point. Unadjusted regression analysis revealed a significant positive association between both the right femural neck and ASMM (β=0.0175; p < 0.001) and the lumbar spine (L1-4) and ASMM β = 0.04; p = 0.04), which remained statistically significant after adjusting for factors that influence BMD, such as gender, BMI, and 25-OH-Vitamin D (right femural neck BMD β=0.01; p=0.002, BMD of the lumbar spine β= 0.04; p=0.02).

Conclusion

In patients with CKD G4-5, low appendicular skeletal muscle mass was associated with low bone mineral density in the hip and spine. The increased fracture risk in patients with CKD may be due to the co-occurrence of osteoporosis and sarcopenia, i.e., osteosarcopenia, although this requires further investigation.

Funding

• Private Foundation Support