scholarly journals Rate of Force Development is Related to Maximal Force, Muscle Quality and Physical Function in Patients With Chronic Kidney Disease Predialysis

2019 ◽  
Author(s):  
Jared M. Gollie ◽  
Michael O. Harris-Love ◽  
Samir S. Patel ◽  
Marc R. Blackman
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Older Men ◽  
Community Dwelling ◽  
Rate Of Force Development ◽  
Muscle Quality ◽  
Middle Aged ◽  
Force Development ◽  
Time Points

ABSTRACTBackgroundPhysical function is severely compromised in people with chronic kidney disease (CKD) and worsens with continued decreases in kidney function. Neuromuscular force capacity is a key determinant of physical function in healthy older adults, though its importance in persons with CKD is less understood.MethodsThis study aimed to determine the relationships among rate of force development (RFD), muscle quality and physical function in a group of community-dwelling, middle-aged and older men (n=14; age=71.2±6.2 years) with CKD stages 3 and 4 (eGFR=37.5±10.4 ml/min per 1.73 m2). Force characteristics were determined from maximal knee extensor isometric contractions and muscle quality was estimated using ultrasound grayscale analysis. Physical function was assessed by the Short Physical Performance Battery (SPPB) and 5-repetition sit-to-stand (STS) test.ResultseGFR was directly related to SPPB (r=0.54, p=0.044) and inversely related to STS (r=-0.62, p=0.029). RFD was positively related to SPPB at time points 0-50 ms, 50-100 ms, and 0-300 ms (RFD0-50, r=0.73, p=0.010; RFD50-100, r=0.67, p=0.022 and RFD0-300 r=0.61, p=0.045); and inversely related to STS at time points 0-50 ms, 50-100 ms, and 0-300 ms (RFD0-50, r=-0.78, p=0.007; RFD50-100, r=-0.78, p=0.006 and RFD0-300 r=-0.76, p=0.009), respectively. RFD was positively associated with maximal voluntary force (MVF) at times 50-100 ms, 100-200 ms, and 0-300 ms (RFD50-100, r=0.72, p=0.011; RFD100-200, r=0.66, p=0.025; and RFD0-300 r=0.70, p=0.016), respectively. Neither MVF nor muscle quality was significantly associated with functional measures.ConclusionsRFD is an important determinant of physical function in middle-aged and older men with CKD stages 3 and 4.

Quality over quantity? Association of skeletal muscle myosteatosis and myofibrosis on physical function in chronic kidney disease

2018 ◽  
Vol 34 (8) ◽  
pp. 1344-1353 ◽  
Author(s):  
Thomas J Wilkinson ◽  
Douglas W Gould ◽  
Daniel G D Nixon ◽  
Emma L Watson ◽  
Alice C Smith
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Physical Performance ◽  
Rating Scale ◽  
Handgrip Strength ◽  
Rectus Femoris ◽  
Muscle Quality ◽  
Muscle Size ◽  
Cross Sectional

Abstract Background Chronic kidney disease (CKD) is characterized by adverse changes in body composition, which are associated with poor clinical outcome and physical functioning. Whilst size is the key for muscle functioning, changes in muscle quality specifically increase in intramuscular fat infiltration (myosteatosis) and fibrosis (myofibrosis) may be important. We investigated the role of muscle quality and size on physical performance in non-dialysis CKD patients. Methods Ultrasound (US) images of the rectus femoris (RF) were obtained. Muscle quality was assessed using echo intensity (EI), and qualitatively using Heckmatt’s visual rating scale. Muscle size was obtained from RF cross-sectional area (RF-CSA). Physical function was measured by the sit-to-stand-60s (STS-60) test, incremental (ISWT) and endurance shuttle walk tests, lower limb and handgrip strength, exercise capacity (VO2peak) and gait speed. Results A total of 61 patients (58.5 ± 14.9 years, 46% female, estimated glomerular filtration rate 31.1 ± 20.2 mL/min/1.73 m2) were recruited. Lower EI (i.e. higher muscle quality) was significantly associated with better physical performance [STS-60 (r = 0.363) and ISWT (r = 0.320)], and greater VO2peak (r = 0.439). The qualitative rating was closely associated with EI values, and significant differences in function were seen between the ratings. RF-CSA was a better predictor of performance than muscle quality. Conclusions In CKD, increased US-derived EI was negatively correlated with physical performance; however, muscle size remains the largest predictor of physical function. Therefore, in addition to the loss of muscle size, muscle quality should be considered an important factor that may contribute to deficits in mobility and function in CKD. Interventions such as exercise could improve both of these factors.

scholarly journals Rate of Force Development Is Related to Maximal Force and Sit-to-Stand Performance in Men With Stages 3b and 4 Chronic Kidney Disease

2021 ◽  
Vol 2 ◽  
Author(s):  
Jared M. Gollie ◽  
Michael O. Harris-Love ◽  
Samir S. Patel ◽  
Nawar M. Shara ◽  
Marc R. Blackman
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Knee Extensor ◽  
Muscle Thickness ◽  
Rectus Femoris ◽  
Rate Of Force Development ◽  
Knee Extensors ◽  
Clinical Trial Registration ◽  
Force Development ◽  
Sit To Stand

Introduction: The primary aims of the present study were to assess the relationships of early (0–50 ms) and late (100–200 ms) knee extensor rate of force development (RFD) with maximal voluntary force (MVF) and sit-to-stand (STS) performance in participants with chronic kidney disease (CKD) not requiring dialysis.Methods: Thirteen men with CKD (eGFR = 35.17 ±.5 ml/min per 1.73 m2, age = 70.56 ±.4 years) and 12 non-CKD men (REF) (eGFR = 80.31 ± 4.8 ml/min per 1.73 m2, age = 70.22 ±.9 years) performed maximal voluntary isometric contractions to determine MVF and RFD of the knee extensors. RFD was measured at time intervals 0–50 ms (RFD0−50) and 100–200 ms (RFD100−200). STS was measured as the time to complete five repetitions. Measures of rectus femoris grayscale (RF GSL) and muscle thickness (RF MT) were obtained via ultrasonography in the CKD group only. Standardized mean differences (SMD) were used to examine differences between groups. Bivariate relationships were assessed by Pearson's product moment correlation.Results: Knee extensor MVF adjusted for body weight (CKD=17.14 ±.1 N·kg0.67, REF=21.55 ±.3 N·kg0.67, SMD = 0.79) and STS time (CKD = 15.93 ±.4 s, REF = 12.23 ±.7 s, SMD = 1.03) were lower in the CKD group than the REF group. Absolute RFD100−200 was significantly directly related to adjusted MVF in CKD (r = 0.56, p = 0.049) and REF (r = 0.70, p = 0.012), respectively. STS time was significantly inversely related to absolute (r = −0.75, p = 0.008) and relative RFD0−50 (r = −0.65, p = 0.030) in CKD but not REF (r = 0.08, p = 0.797; r = 0.004, p = 0.991). Significant inverse relationships between RF GSL adjusted for adipose tissue thickness and absolute RFD100−200 (r =−0.59, p = 0.042) in CKD were observed.Conclusion: The results of the current study highlight the declines in strength and physical function that occur in older men with CKD stages 3b and 4 not requiring dialysis. Moreover, early RFD was associated with STS time in CKD while late RFD was associated MVF in both CKD and REF.Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT03160326 and NCT02277236.

scholarly journals The association between changes in lifestyle behaviors and the incidence of chronic kidney disease (CKD) in middle-aged and older men

2017 ◽  
Vol 27 (8) ◽  
pp. 389-397 ◽  
Author(s):  
Ryoma Michishita ◽  
Takuro Matsuda ◽  
Shotaro Kawakami ◽  
Satoshi Tanaka ◽  
Akira Kiyonaga ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Older Men ◽  
Lifestyle Behaviors ◽  
Middle Aged

scholarly journals Examining the utility of cystatin C as a confirmatory test of chronic kidney disease across the age range in middle-aged and older community-dwelling adults

2018 ◽  
Vol 72 (4) ◽  
pp. 287-293 ◽  
Author(s):  
Mark Canney ◽  
Donal J Sexton ◽  
Neil O’Leary ◽  
Martin Healy ◽  
Rose Anne Kenny ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cystatin C ◽  
Community Dwelling ◽  
Confirmatory Test ◽  
Middle Aged ◽  
Predicted Probability ◽  
Ckd Stage ◽  
Age Range

BackgroundCystatin C has been proposed as a confirmatory test of chronic kidney disease (CKD). This is most applicable to older individuals with CKD, the majority of whom have a creatinine-based estimated glomerular filtration rate (eGFR) of 45–59 mL/min/1.73 m2 (CKD stage 3a). We sought to examine the utility of cystatin C as a confirmatory test of CKD across the age range in the general population of older adults.MethodsCross-sectional analysis of 5386 participants from The Irish Longitudinal Study on Ageing, a cluster-sampled national cohort of community-dwelling adults aged ≥50 years. Cystatin C and creatinine were measured simultaneously using standardised assays. Using generalised additive models, we modelled the distributions of creatinine and cystatin C per year of age from four distributional parameters: location, dispersion, skewness, kurtosis. Among participants with CKD stage 3a, we estimated the predicted probability of cystatin C eGFR <60 mL/min/1.73 m2 (‘confirmed CKD’) as a function of age.ResultsMedian age was 62 years, 53% were female and median cystatin C eGFR was 80 mL/min/1.73 m2. We observed progressive variability in cystatin C with increasing age. Compared with creatinine, cystatin C levels rose sharply beyond the age of 65. Among participants with CKD stage 3a (n=463), the predicted probability of ‘confirmed CKD’ increased steadily with age, from 15% at age 50 to 80% at age 80.ConclusionsThe clinical utility of cystatin C may be maximised in middle-aged individuals, in whom the distribution of cystatin C is less variable than older adults, and the pretest probability of confirming CKD is lower.

scholarly journals Chronic kidney disease: prevalence and association with handgrip strength in a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yang Cheng ◽  
Min Liu ◽  
Yu Liu ◽  
Haifeng Xu ◽  
Xiaotian Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Handgrip Strength ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Age Related ◽  
Chronic Kidney Disease Prevalence

Abstract Background Poor physical function is strongly associated with mortality and poor clinical outcomes in adults with chronic kidney disease (CKD). Handgrip strength (HGS) is an important index for physical function in the general population, and the association between HGS and CKD is worth investigating. Methods From September to November 2015, we conducted a cross-sectional study consisting of 10,407 participants in Jurong City, China. Age-related and sex-specific HGS percentile curves were constructed using the GAMLSS method. In addition, logistic regression was applied to estimate the association between HGS and the presence of CKD with odds ratios (ORs) and 95 % confidence intervals (CIs). Results Participants with low HGS tended to be older and were more likely to have CKD (8.73 %). Smoothed centile curves of HGS showed a similar shape in both sexes: participants peaked at approximately 20–35 years old and gradually decreased after the age of 50. In addition, independent of age and other factors, the decreased presence of CKD was significantly identified in individuals with moderate (OR: 0.64, 95 % CI: 0.49–0.83) and high HGS (OR: 0.37, 95 % CI: 0.23–0.58). Conclusions We concluded that HGS was significantly negatively associated with CKD in Chinese community-dwelling persons.

scholarly journals Long-term Body Weight Gain After Maturity is Associated With the Incidence of Chronic Kidney Disease (CKD), Independent of Current Body Weight, in Middle-aged and Older Men

2019 ◽  
Vol 29 (6) ◽  
pp. 213-219 ◽  
Author(s):  
Ryoma Michishita ◽  
Takuro Matsuda ◽  
Shotaro Kawakami ◽  
Satoshi Tanaka ◽  
Akira Kiyonaga ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Body Weight ◽  
Weight Gain ◽  
Kidney Disease ◽  
Body Weight Gain ◽  
Older Men ◽  
Middle Aged

scholarly journals The Association Between Unhealthy Lifestyle Behaviors and the Prevalence of Chronic Kidney Disease (CKD) in Middle-Aged and Older Men

2016 ◽  
Vol 26 (7) ◽  
pp. 378-385 ◽  
Author(s):  
Ryoma Michishita ◽  
Takuro Matsuda ◽  
Shotaro Kawakami ◽  
Akira Kiyonaga ◽  
Hiroaki Tanaka ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Older Men ◽  
Lifestyle Behaviors ◽  
Middle Aged ◽  
Unhealthy Lifestyle

scholarly journals Elevated alanine aminotransferase and low aspartate aminotransferase/alanine aminotransferase ratio are associated with chronic kidney disease among middle-aged women: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Akihiro Watanabe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Relationship Of

Abstract Background Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. Methods The present study included 29,133 women aged 40 to 64 years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT > 40 U/L and GGT > 50 U/L were determined as elevated, AST/ALT ratio < 1 was regarded as low, and CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. Results “Elevated ALT and elevated GGT” and “elevated ALT and non-elevated GGT” significantly increased the OR for CKD when compared with “non-elevated ALT and non-elevated GGT” (OR: 2.56, 95% CI: 2.10–3.12 and OR: 2.24, 95% CI: 1.81–2.77). Compared with “AST/ALT ratio ≥ 1 and non-elevated GGT”, “AST/ALT ratio < 1 and elevated GGT” and “AST/ALT ratio < 1 and non-elevated GGT” significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36–3.15 and OR: 1.68, 95% CI: 1.52–1.87). These findings still remained after adjustment for confounders. Conclusions Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.

MO491ASSOCIATION BETWEEN SERUM URIC ACID LEVEL AND CHRONIC KIDNEY DISEASE INCIDENCE STRATIFIED BY SEX IN MIDDLE-AGED ADULTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Shingo Nakayama ◽  
Michihiro Satoh ◽  
Takahisa Murakami ◽  
Yukako Tatsumi ◽  
Tomoko Muroya ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Health Check ◽  
Middle Aged ◽  
Men And Women ◽  
Increased Risk ◽  
The Mean ◽  
Middle Aged Adults

Abstract Background and Aims While previous studies have reported the association between serum uric acid (SUA) and chronic kidney disease (CKD) incidence, the sex differences in this association remain controversial. Therefore, we examined the association between SUA levels and CKD incidence in middle-aged adults stratified by sex using data from a large-scale health check-up. Method We analyzed information from the JMDC database, which included the annual health check-up data of Japanese employees and their dependents aged &lt;75 years. Among those individuals, we analyzed data from 138,511 individuals without CKD, kidney disease, or a history of cardiovascular disease at baseline. CKD was defined as an estimated glomerular filtration rate (eGFR) &lt;60 mL/min/1.73 m2 and/or proteinuria. We divided the participants into 9 and 7 groups according to SUA levels for men and women, respectively. A Cox model was applied to assess the adjusted hazard ratios (HRs) for CKD incidence in each SUA level group using an SUA concentration of 4.0–4.9 mg/dL as the reference after adjusting for age, body mass index, current or ex-smoker, current or ex-drinker, diabetes mellitus, dyslipidemia, systolic blood pressure, use of anti-hyperuricemic drugs, and baseline eGFR. Results The mean participant age was 44.1 years, and 29.6% were women. The mean SUA levels were 5.9 mg/dL and 4.1 mg/dL in men and women, respectively. During the mean follow-up period of 4.68 years, 12,589 participants developed CKD. The age-standardized incidence rates for CKD were 17.88/17.80 per 1000 person-years in men/women with SUA concentrations of 4.0–4.9 mg/dL, 209.76 per 1000 person-years in men with SUA ≥11.0 mg/dL, and 73.38 per 1000 person-years in women with SUA ≥ 9.0 mg/dL. The fully adjusted HRs (95% confidence interval [CI], P value) for CKD incidence in the groups with SUA concentrations of &lt;4.0, 10.0–10.9, and ≥11.0 mg/dL compared with those with SUA of 4.0–4.9 mg/dL among men were 1.13 (1.01–1.26, P=0.030), 1.98 (1.32–2.97, P=0.0010), and 3.74 (1.68–8.35, P=0.0013), respectively. In women, the fully adjusted HRs for CKD incidence in the groups with SUA concentrations of &lt;4.0, 8.0–8.9, and ≥9.0 mg/dL were 1.08 (1.01–1.16, P=0.032), 2.39 (1.07–5.35, P=0.034), and 3.20 (0.80–12.8, P=0.10), respectively. Similar results were observed when we performed the sensitivity analysis excluding 8,411 individuals with hypertensive treatment from the main analysis. The HRs for the outcomes caused by the onset of eGFR &lt;60 mL/min/1.73 m2 or proteinuria separately were similar to those for the main results. Conclusion The results of the present study demonstrated an increased risk of CKD in men with SUA concentrations of &lt;4.0 and ≥10.0 mg/dL and &lt;4.0 and ≥8.0 mg/dL in women compared to those with SUA concentrations of 4.0–4.9 mg/dL after adjusting for various covariates. Both high and low SUA levels were risk factors for CKD in middle-aged men and women. Hyperuricemia was demonstrated to cause renal injury due to the intraluminal deposition of uric acid crystals in the renal collecting duct. Hyperuricemia may also induce endothelial dysfunction, activation of the renin-angiotensin system, and induction of inflammation and stimulation of vascular smooth muscle cell proliferation by the induction of cyclooxygenase-2. However, as uric acid is one of the most important antioxidants in human plasma, low SUA levels may increase the risk of CKD incidence through decreased antioxidant activity. These mechanisms are implicated in the pathogenesis of CKD caused by high and low SUA levels. In addition, the SUA levels and ranges associated with increased risks of CKD incidence differed by sex.

Pretransplant Comprehensive Geriatric Assessment in Older Patients with Advanced Chronic Kidney Disease

Nephron ◽  
2021 ◽  
pp. 1-10
Author(s):  
Teddy Novais ◽  
Elodie Pongan ◽  
Frederic Gervais ◽  
Marie-Hélène Coste ◽  
Emmanuel Morelon ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Activities Of Daily Living ◽  
Physical Function ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
Older Patients ◽  
Advanced Chronic Kidney Disease ◽  
Comorbidity Burden

<b><i>Background:</i></b> In older patients with advanced chronic kidney disease (CKD), the decision of kidney transplantation (KT) is a challenge for nephrologists. The use of comprehensive geriatric assessment (CGA) is increasingly gaining interest into the process of decision-making about treatment modality choice for CKD. The aim of this study was to assess the prevalence of geriatric impairment and frailty in older dialysis and nondialysis patients with advanced CKD using a pretransplant CGA model and to identify geriatric impairments influencing the geriatricians’ recommendations for KT. <b><i>Methods:</i></b> An observational study was conducted with retrospective data from July 2017 to January 2020. Patients aged ≥65 years with advanced CKD, treated or not with dialysis, and referred by the nephrologist were included in the study. The CGA assessed comorbidity burden, cognition, mood, nutritional status, (instrumental) activities of daily living, physical function, frailty, and polypharmacy. Geriatric impairments influencing the geriatricians’ recommendations for KT were identified using univariate and multivariate logistic regressions. <b><i>Results:</i></b> 156 patients were included (74.2 ± 3.5 years and 62.2% on dialysis). Geriatric conditions were highly prevalent in both dialysis and nondialysis groups. The rate of geriatric impairments was higher in dialysis patients regarding comorbidity burden, symptoms of depression, physical function, autonomy, and frailty. Geriatrician’s recommendations for KT were as follows: favorable (79.5%) versus not favorable or multidisciplinary discussion needed with nephrologists (20.5%). Dependence for Instrumental Activities of Daily Living (IADL) (odds ratio [OR] = 3.01 and 95% confidence interval [CI] = 1.30–7.31), physical functions (OR = 2.91 and 95% CI = 1.08–7.87), and frailty (OR = 2.66 and 95% CI = 1.07–6.65) were found to be independent geriatric impairments influencing geriatrician’s recommendations for KT. <b><i>Conclusions:</i></b> Understanding the burden of geriatric impairment provides an opportunity to direct KT decision-making and to guide interventions to prevent functional decline and preserve quality of life.

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