Skeletal muscle mass is associated with erythropoietin response in hemodialysis patients

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.

Download Full-text

Skeletal Muscle Mass Is Associated With Erythropoietin Response in Hemodialysis Patients

10.21203/rs.3.rs-139779/v1 ◽

2021 ◽

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 ◽

Maintenance Hemodialysis ◽

Weekly Dose ◽

Cross Sectional

Abstract Background: Hyporesponsiveness to erythropoietin stimulating agent (ESA) is associated with poor outcome in patients with chronic kidney disease. Although ESA hyporesponsiveness and sarcopenia have common pathophysiological background, clinical evidence linking them are scarce. The purpose of the study was to investigate the relationship between ESA responsiveness and skeletal muscle mass in hemodialysis patient. 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 weekly dose of ESA divided by body weight and hemoglobin (IU/kg/week/dL), and weekly dose of ESA/hemoglobin (IU/week/dL). Dose of ESA was equivalated with 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), whereas 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.

Download Full-text

MO731ASSOCIATION BETWEEN SKELETAL MUSCLE MASS AND INTRADIALYTIC HYPOTENSION IN PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab097.0011 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Hyung Eun Son ◽

Eunji Baek ◽

Ji Young Ryu ◽

Sejoong Kim ◽

Ho Jun Chin ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Weight ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Handgrip Strength ◽

Intracellular Water ◽

Maintenance Hemodialysis ◽

Intradialytic Hypotension ◽

Total Water ◽

Skeletal Muscle Index

Abstract Background and Aims Patients undergoing hemodialysis showed higher prevalence of sarcopenia than that of the healthy. As an intracellular water reservoir, skeletal muscle mass would be important to predict intradialytic hypotension. This study was designed to reveal the effect of skeletal muscle mass to intradialytic hypotension, which is also an indicator of volume status in patients under hemodialysis. Method 150 patients from three hemodialysis centers in 2016 and 38 patients from one center under maintenance hemodialysis in 2020 were enrolled in this study, and total 177 patients were finally analyzed. We measured skeletal muscle mass, intracellular water, extracellular water, total body water and phase angle in 50 kHz by bio-impedance analysis just after a hemodialysis session. Information including laboratory tests, chest x-ray, handgrip strength, mid-arm circumference and questionnaire to ask the patients’ general condition was collected. Intradialytic hypotension over three months was observed. We analyzed several factors including skeletal muscle mass which would have association with intradialytic hypotension over three months by multivariate logistic regression model. Results Tertile subgroups divided by the ratio of skeletal muscle to body weight defined as skeletal muscle index were compared. Patients in low skeletal muscle index had a higher rate of intradialytic hypotension (41%) while that of intermediate group was 20% and high group was 5%. Patients in low skeletal muscle mass index group was female-dominant, more obese, more diabetic and had lower handgrip strength than higher skeletal muscle index group. In patients who had higher skeletal muscle mass to body weight, the risk of Intradialytic hypotension was decreased (HR: 0.80 [95% CI 0.75-0.88], adjusted HR: 0.73 [95% CI 0.64–0.84]). Comparing tertile groups by skeletal muscle index, patients in the group of higher skeletal muscle mass index showed lower rate of intradialytic hypotension during hemodialysis, which was similar in inverse probability of treatment weighted analysis. Confounders were age, gender, diabetes mellitus, heart failure, ischemic heart disease, the ratio of ultrafiltration amount to body weight and skeletal muscle index. Model including skeletal muscle index and clinical parameters showed highest AUC area (0.877 [95% 0.823-0.930]) when the model including clinical parameters only (AUC area: 0.807 [95% CI 0.735-0.879]) or with each bioimpedance index (skeletal muscle mass to squared height, AUC area: 0.843 [95% CI 0.823-0.931]; the ratio of extracellular water to total water, AUC area: 0.809 [95% CI 0.736-0.883]; the ratio of intracellular water to total water, AUC area: 0.811 [95% CI 0.738-0.885] and phase angle, AUC area: 0.812 [95% CI 0.738-0.886]). Conclusion This study showed correlation between skeletal muscle mass by body weight and intradialytic hypotension. It especially suggested that skeletal muscle mass to weight would be a good predictor of intradialytic hypotension and would be helpful to decide appropriate dry body weight in hemodialysis.

Download Full-text

Body composition and energy intake — skeletal muscle mass is the strongest predictor of food intake in obese adolescents: The HEARTY trial

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2015-0479 ◽

2016 ◽

Vol 41 (6) ◽

pp. 611-617 ◽

Cited By ~ 37

Author(s):

Jameason D. Cameron ◽

Ronald J. Sigal ◽

Glen P. Kenny ◽

Angela S. Alberga ◽

Denis Prud’homme ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Body Weight ◽

Muscle Mass ◽

Energy Intake ◽

Skeletal Muscle Mass ◽

Fat Free Mass ◽

Cross Sectional ◽

Percentage Body Fat ◽

Obese Adolescents

There has been renewed interest in examining the relationship between specific components of energy expenditure and the overall influence on energy intake (EI). The purpose of this cross-sectional analysis was to determine the strongest metabolic and anthropometric predictors of EI. It was hypothesized that resting metabolic rate (RMR) and skeletal muscle mass would be the strongest predictors of EI in a sample of overweight and obese adolescents. 304 post-pubertal adolescents (91 boys, 213 girls) aged 16.1 (±1.4) years with body mass index at or above the 95th percentile for age and sex OR at or above the 85th percentile plus an additional diabetes risk factor were measured for body weight, RMR (kcal/day) by indirect calorimetry, body composition by magnetic resonance imaging (fat free mass (FFM), skeletal muscle mass, fat mass (FM), and percentage body fat), and EI (kcal/day) using 3 day food records. Body weight, RMR, FFM, skeletal muscle mass, and FM were all significantly correlated with EI (p < 0.005). After adjusting the model for age, sex, height, and physical activity, only FFM (β = 21.9, p = 0.007) and skeletal muscle mass (β = 25.8, p = 0.02) remained as significant predictors of EI. FFM and skeletal muscle mass also predicted dietary protein and fat intake (p < 0.05), but not carbohydrate intake. In conclusion, with skeletal muscle mass being the best predictor of EI, our results support the hypothesis that the magnitude of the body’s lean tissue is related to absolute levels of EI in a sample of inactive adolescents with obesity.

Download Full-text

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

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0960 ◽

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.

Download Full-text

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

Journal of Nephrology ◽

10.1007/s40620-020-00871-5 ◽

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

Download Full-text

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

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfx172.mp437 ◽

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

Download Full-text

Creatinine/(cystatin C × body weight) ratio is associated with skeletal muscle mass index

Endocrine Journal ◽

10.1507/endocrj.ej19-0542 ◽

2020 ◽

Vol 67 (7) ◽

pp. 733-740 ◽

Cited By ~ 1

Author(s):

Kensuke Nishida ◽

Yoshitaka Hashimoto ◽

Ayumi Kaji ◽

Takuro Okamura ◽

Ryousuke Sakai ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Weight ◽

Muscle Mass ◽

Cystatin C ◽

Skeletal Muscle Mass ◽

Weight Ratio ◽

Body Weight Ratio ◽

Skeletal Muscle Mass Index

Download Full-text

Growth differentiation factor 15 (GDF-15) inhibition to increase muscle mass and function in cancer cachexia.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e15633 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e15633-e15633

Author(s):

Matthew Peloquin ◽

Brianna LaCarubba ◽

Stephanie Joaqium ◽

Gregory Weber ◽

John Stansfield ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Weight ◽

Muscle Mass ◽

Muscle Function ◽

Skeletal Muscle Mass ◽

Cancer Cachexia ◽

Tumor Model ◽

Growth Differentiation Factor 15 ◽

Myostatin Inhibition ◽

And Function

e15633 Background: Almost half of cancer deaths are attributed to cancers most frequently associated with cachexia. Cachexia is a complex metabolic disease characterized by anorexia and unintentional weight loss. Skeletal muscle depletion has been recognized as a key feature of the disease, however muscle anabolic therapies have not been successful, suggesting that treatments that target multiple aspects of the disease will be most effective. Growth differentiation factor 15 (GDF-15) is a cytokine that induces anorexia and weight loss and is associated with cachexia in cancer patients. In preclinical cancer cachexia models, GDF-15 inhibition is sufficient to normalize food intake and body weight, including skeletal muscle mass. However, it remains to be determined whether the increased skeletal muscle mass also results in restoration of muscle function. Therefore, we examined the effect of GDF-15 inhibition on muscle mass and function in mouse models of cancer cachexia in comparison with myostatin inhibition, an established muscle anabolic pathway. Methods: Cachectic mouse tumor models were established with subcutaneous implantation of tumor cell lines reported to be GDF-15-dependent; mouse renal cell carcinoma (RENCA) and human ovarian cancer (TOV-21G) cell lines. Mice were treated with anti-GDF-15 (mAB2) or anti-myostatin (RK35) monoclonal antibodies and skeletal muscle function was assessed in vivo via maximum force, maximum rate of contraction and half relax time. In the RENCA tumor model, GDF-15 inhibition fully restored body weight and skeletal muscle mass whereas myostatin inhibition showed only a modest effect. Results: Consistent with the muscle mass improvement, GDF-15 inhibition dramatically increased functional muscle endpoints compared to the partial effect of myostatin inhibition. Interestingly, in the TOV-21G tumor model GDF-15 inhibition only partially restored body weight, however skeletal muscle mass and muscle function were completely normalized. Consistent with the functional assessment, GDF-15 inhibition in the RENCA tumor model decreased the expression of several catabolic genes (i.e. Trim63, Fbxo32, Myh7 and Myh2). The GDF-15 effect is likely to be secondary to the reversal of anorexia since wildtype mice pair-fed to Fc-GDF-15-treated mice demonstrated equivalent muscle mass loss. Conclusions: Taken together these data suggest that GDF-15 inhibition holds potential as an effective therapeutic approach to alleviate multiple aspects of cachexia.

Download Full-text

Mesenchymal Stem Cell-Derived Exosomes Protect Muscle Loss by miR-145-5p Activity Targeting Activin A Receptors

Cells ◽

10.3390/cells10082169 ◽

2021 ◽

Vol 10 (8) ◽

pp. 2169

Author(s):

Kyung-Ah Cho ◽

Da-Won Choi ◽

Yu-Hee Kim ◽

Jungwoo Kim ◽

Kyung-Ha Ryu ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Weight ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Total Body Weight ◽

Activin A ◽

Dependent Manner ◽

Muscle Loss ◽

Total Body

Skeletal muscle mass is decreased under a wide range of pathologic conditions. In particular, chemotherapy is well known for inducing muscle loss and atrophy. Previous studies using tonsil-derived mesenchymal stem cells (T-MSCs) or a T-MSC-conditioned medium showed effective recovery of total body weight in the chemotherapy-preconditioned bone marrow transplantation mouse model. This study investigated whether extracellular vesicles of T-MSCs, such as exosomes, are a key player in the recovery of body weight and skeletal muscle mass in chemotherapy-treated mice. T-MSC exosomes transplantation significantly decreased loss of total body weight and muscle mass in the busulfan-cyclophosphamide conditioning regimen in BALB/c recipient mice containing elevated serum activin A. Additionally, T-MSC exosomes rescued impaired C2C12 cell differentiation in the presence of activin A in vitro. We found that T-MSC exosomes possess abundant miR-145-5p, which targets activin A receptors, ACVR2A, and ACVR1B. Indeed, T-MSC exosomes rescue muscle atrophy both in vivo and in vitro via miR-145-5p dependent manner. These results suggest that T-MSC exosomes have therapeutic potential to maintain or improve skeletal muscle mass in various activin A elevated pathologic conditions.

Download Full-text