Association of Serum Indoxyl Sulfate Levels with Skeletal Muscle Mass and Strength in Chronic Hemodialysis Patients: A 2-year Longitudinal Analysis

2020 ◽  
Vol 107 (3) ◽  
pp. 257-265
Author(s):  
Yu-Li Lin ◽  
Chin-Hung Liu ◽  
Yu-Hsien Lai ◽  
Chih-Hsien Wang ◽  
Chiu-Huang Kuo ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Longitudinal Analysis ◽  
Skeletal Muscle Mass ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Indoxyl Sulfate

scholarly journals Skeletal muscle mass is associated with erythropoietin response in hemodialysis patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tomoaki Takata ◽  
Yukari Mae ◽  
Kentaro Yamada ◽  
Sosuke Taniguchi ◽  
Shintaro Hamada ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Weight ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Linear Regression Analysis ◽  
Transferrin Saturation ◽  
Resistance Index ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Weekly Dose

Abstract Background Hyporesponsiveness to erythropoietin stimulating agent (ESA) is associated with poor outcomes in patients with chronic kidney disease. Although ESA hyporesponsiveness and sarcopenia have a common pathophysiological background, clinical evidence linking them is scarce. The purpose of the study was to investigate the relationship between ESA responsiveness and skeletal muscle mass in hemodialysis patients. Methods This cross-sectional study analyzed 70 patients on maintenance hemodialysis who were treated with ESA. ESA responsiveness was evaluated by erythropoietin resistance index (ERI), calculated as a weekly dose of ESA divided by body weight and hemoglobin (IU/kg/week/dL), and a weekly dose of ESA/hemoglobin (IU/week/dL). A dose of ESA is equivalated to epoetin β. Correlations between ESA responsiveness and clinical parameters including skeletal muscle mass were analyzed. Results Among the 70 patients, ERI was positively correlated to age (p < 0.002) and negatively correlated to height (p < 0.001), body weight (p < 0.001), BMI (p < 0.001), skeletal muscle mass (p < 0.001), transferrin saturation (TSAT) (p = 0.049), and zinc (p = 0.006). In the multiple linear regression analysis, TSAT, zinc, and skeletal muscle mass were associated with ERI and weekly ESA dose/hemoglobin. Conclusions Skeletal muscle mass was the independent predictor for ESA responsiveness as well as TSAT and zinc. Sarcopenia is another target for the management of anemia in patients with hemodialysis.

P0960HOME BASED RESISTANCE EXERCISE PROGRAM AND SARCOPENIA IN HEMODIALYSIS PATIENTS: IT IS A USEFUL INTERVENTION?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vicent Esteve Simó ◽  
Anna Junqué Jiménez ◽  
Verónica Duarte Gallego ◽  
Irati Tapia González ◽  
Fátima Moreno Guzmán ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Resistance Exercise ◽  
Muscle Mass ◽  
Functional Capacity ◽  
Muscular Strength ◽  
Skeletal Muscle Mass ◽  
Exercise Program ◽  
Hemodialysis Patients ◽  
Home Based

Abstract Background and Aims Sarcopenia is a skeletal muscle disorder associated with adverse outcomes including falls, physical disability and mortality particularly in hemodialysis (HD) patients. Currently, progressive resistance training exercise has been shown a proven method to treat and prevent sarcopenia. Nevertheless, these findings are poorly investigated in HD patients since exercise programs are not widespread. The aim of our study was to assess the effect of a home-based resistance exercise program (HBREP) on muscular strength, functional capacity and body composition in our hemodialysis patients with sarcopenia according to the European Working Group on Sarcopenia in Older People criteria (EWGSOP2). Method A 12 weeks single-center prospective study. HD patients from our institution with EWGSOP2 sarcopenia diagnosis were enrolled in a HBREP. Demographical an anthropometrical data, main biochemical and nutritional parameters, hand grip (HG) muscular strength, functional capacity tests: Sit to stand to seat 5 (STS5); Short Physical Performance Battery (SPPB), gait speed (GS), as well as body composition determined by electrical bioimpedance (BIA) and sarcopenia severity were analized. Results 18 HD patients with sarcopenia (71.4% severe) were included (4 drop out).78.6% men. Mean age 74.7 years and 53.3 months on HD. The main etiologies of ESRD were the HBP (21.4%) and DM (14.3%). Globally, a significant improvement was observed at the end of the study in relation to muscular strength (HG 19.9±6.1 vs 22.2±7.1 kg, p 0.001) and functional capacity tests (STS5 21.9±10.3 vs 17.2±9.9 sec, p 0.001; SPPB (6.9±2.3 vs 9.1±2.5 score, p 0.001 and GS 0.8±0.1 vs 0.9±0.2 m/s, p 0.015). Likewise, higher total skeletal muscle mass (SMM, 14.3±2.8 vs 14.5±2.9 kg) and SMM index (SMM/height2, 5.5±0.7 vs 5.7±0.9 Kg/m2 ) were found at the end of the study, although these differences were not significant. Finally, 2 patients (14.8%) reverse the EWGSOP2 sarcopenia criteria and 3 (21.4%) enhanced their severe sarcopenia. No relevant changes regarding anthropometrical data, main biochemical and nutritional parameters or dialysis adequacy were observed at the end of the study. Conclusion A home-based resistance exercise program improves muscular strength, functional capacity and body composition in our sarcopenic hemodialysis patients. With our results, home-based resistance exercise programs should be considered a key point in the prevention and treatment of skeletal muscle mass reduction due to sarcopenia in these patients. Further studies are mandatory to confirm our encouraging results.

scholarly journals Feasibility of computed tomography-based assessment of skeletal muscle mass in hemodialysis patients

2020 ◽  
Author(s):  
Tomoaki Takata ◽  
Aki Motoe ◽  
Katsumi Tanida ◽  
Sosuke Taniguchi ◽  
Ayami Ida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Hemodialysis Patients

scholarly journals MP437FACTORS RELATED TO THE DECREASE IN SKELETAL MUSCLE MASS IN HEMODIALYSIS PATIENTS

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii589-iii590
Author(s):  
Hiroshi Ogawa ◽  
Toshimitsu Koga ◽  
Yoshihiro Ota ◽  
Yuko Kojima ◽  
Azumi Sato ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Hemodialysis Patients

scholarly journals Skeletal Muscle Mass Index Is Positively Associated With Bone Mineral Density in Hemodialysis Patients

2020 ◽  
Vol 7 ◽  
Author(s):  
Kiyonori Ito ◽  
Susumu Ookawara ◽  
Yutaka Hibino ◽  
Sojiro Imai ◽  
Mariko Fueki ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Bone Mineral ◽  
Skeletal Muscle Mass ◽  
Hemodialysis Patients ◽  
Mineral Density ◽  
Skeletal Muscle Mass Index

P1566SKELETAL MUSCLE MASS BY COMPUTED TOMOGRAPHY AT THE LEVEL OF THE THIRD LUMBAR VERTEBRA AND MORTALITY IN END-STAGE KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alice Sabatino ◽  
Giuseppe Regolisti ◽  
Marco Delsante ◽  
Tommaso Di motta ◽  
Alice Parmigiani ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Ct Scan ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Lumbar Vertebra ◽  
Chronic Hemodialysis ◽  
End Stage Kidney Disease ◽  
End Stage ◽  
Fourth Quartile

Abstract Background and Aims Protein-Energy Wasting (PEW) is highly prevalent in patients with end-stage kidney disease on chronic hemodialysis (ESKD-HD). In such clinical setting PEW is associated to poor outcomes. The assessment of nutritional status is essential for the identification of patients at risk for the development of PEW. In the contest of nutritional evaluation, increasing attention is currently paid to the assessment of muscle mass, which represent the major protein asset in the body. Currently available bedside tools used for the assessment of nutritional status are not accurate enough for the assessment o skeletal muscle mass. In this clinical setting, the use of “gold standard” imaging methods (such as CT sca, DEXA or MRI) could allow a more accurate assessment of body composition. The aim of our study was to assess the correlation between skeletal muscle mass on the level of the third lumbar vertebra (L3) assessed by CT scan with mortality in ESKD-HD. Method In a retrospective observational study, 1260 ESKD-HD patients undergoing chronic hemodialysis treatment were identified between 2008 and 2015 in the Dialysis Centers of the National Health Service in the province of Parma. Among these patients, those with at least one available abdomen CT scan after the patient had already been on dialysis for at least 6 months were enrolled. The CT images obtained at the level corresponding to the L3 were analyzed using a dedicated software, in order to extrapolate the data related to the quantity of skeletal muscle tissue. Results We enrolled 183 ESKD-HD patients, aged 68.8 (± 15.1) yrs, 64% (117/183) males, median hemodialysis vintage 43.9 (range 6 – 208) months. The cohort was characterized by a high comorbidity burden, with a median Charlson Comorbidity Index of 9 (range 2-17). Baseline skeletal muscle mass at L3 was 118.5 cm2 (± 30.6). Median follow-up was 65.6 (range 6.6 – 132.5) months. During follow-up, 67% (122/183) of patients died. Patients were divided based on quartiles of muscle mass. Patients in the first quartile had 83% mortality, while mortality of patients in the fourth quartile was 52% (OR = 4.16 95% CI = 1.59 – 10.87; P = 0.003). Kaplan-Meier analysis identified significantly lower survival in patients in the first quartile of muscle mass compared to those in the fourth quartile (P = 0.03 at the Mantel-Cox Log-rank test) (Figure 1). Conclusion Low muscle mass by CT scan appears to be associated with an increased risk of mortality in ESKD on chronic hemodialysis.

scholarly journals SUN-257 COMPARISON OF DIFFERENT METHODS OF NORMALIZING SKELETAL MUSCLE MASS TO DIAGNOSE SARCOPENIA AMONG HEMODIALYSIS PATIENTS

2020 ◽  
Vol 5 (3) ◽  
pp. S307
Author(s):  
H.Y. PARK ◽  
K.S. Jung ◽  
M.H. Lee ◽  
K.Y. Lee ◽  
S. Yoon ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Hemodialysis Patients
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