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Uremic sarcopenia is a process of progressive loss of muscle mass that is associated with a sedentary lifestyle and compromised cardiovascular health, leading to increased morbidity and mortality in these patients. Among the factors that explain sarcopenia in this population are metabolic acidosis, dietary restrictions, sedentary lifestyle, lower protein synthesis, greater muscle proteolysis, increased inflammatory cytokines, among others. Handgrip strength (HGS) is a method that assesses muscle strength and is associated with muscle mass, nutritional and inflammatory status. The objective of this study was to correlate the clinical biomarker creatinine/cystatin ratio, already used in other populations as an indicator of muscle mass, with handgrip strength and lean mass seen by BIA and DEXA.
This study is part of a follow-up cohort of non-dialysis chronic kidney disease patients who were monitored for 3 years, in which a cross-section was carried out including 134 patients and clinical and laboratory data were collected. Differences between independent variables were assessed using the t or Mann-Whitney test. Correlations were evaluated using the Spearman or Pearson coefficient.
134 patients were evaluated, with a mean age of 67.8+/-8.5 years, 70 (52.2%) women and 65 (48.5%) men. It was found that altered handgrip strength was present in 13 (20%) men and 11 (15.7%) women. The diagnosis of sarcopenia made by FPP and confirmed by lean mass by DEXA/BIA was verified in 17 (24.5%) women and 37 (56%) men. The creatinine/cystatin ratio correlated with FPP (r=0.49 p<0.001), with calf conditions (r=0.17 p=0.04) and lean mass by BIA (r=025 p= 0.003) but there was no manifestation of lean mass by DEXA.
The lower creatinine/cystatin ratio proved to be a good clinical indicator suggestive of sarcopenia in a population of chronic kidney disease patients, correlating with handgrip strength, lean body mass by BIA, calf circumference, however there was no correlation with lean mass by DEXA.