scholarly journals Relationship between Serum Vitamin D and Leg Strength in Older Adults with Pre-Dialysis Chronic Kidney Disease: A Preliminary Study

2020 ◽  
Vol 17 (4) ◽  
pp. 1433
Author(s):  
Akira Saito ◽  
Koji Hiraki ◽  
Yuhei Otobe ◽  
Kazuhiro P. Izawa ◽  
Tsutomu Sakurada ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Knee Extensor ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
Lower Extremity Muscle ◽  
Knee Extensor Muscle Strength

Active vitamin D (calcitriol, or 1.25 (OH) 2 D) is associated with muscle weakness, falls, and fracture in community-dwelling older people. This study aimed to investigate the relationship between a serum active vitamin D level and lower extremity muscle strength in elderly patients with pre-dialysis chronic kidney disease (CKD). This cross-sectional study included 231 patients with CKD treated conservatively as outpatients. We analyzed patient background factors, including age, sex, body mass index (BMI), intact parathyroid hormone (PTH), phosphorus, calcium, albumin, serum calcitriol level as an indicator of active vitamin D, and estimated glomerular filtration rate (eGFR) collected from medical records. As an index of lower extremity muscle strength, the isometric knee extension muscle strength-to-weight ratio (kgf/kg) was calculated. The mean patient age was 75.9 ± 6.1 years (68.8% male), and the BMI was 24.1 ± 3.8 kg/m2. A significant correlation was observed between knee extensor muscle strength and serum calcitriol level (r = 0.32, p < 0.01), age (r = –0.30, p < 0.01), BMI (r = −0.31, p < 0.01), intact PTH (r = −0.22, p < 0.01), phosphorus (r = −0.29, p < 0.01), albumin (r = −0.28, p < 0.01), and eGFR (r = 0.25, p < 0.01). Multiple regression analysis showed calcitriol to be significantly associated with knee extensor muscle strength (β: 0.14, 95% confidence interval: 0–0.002, p = 0.04) after adjustment for covariates. These results suggest that the serum active vitamin D level is associated with lower extremity muscle strength in older adults with pre-dialysis CKD. It is necessary to verify whether vitamin D supplementation increases lower extremity muscle strength in pre-dialysis CKD patients.

scholarly journals Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chisato Hayashi ◽  
Soshiro Ogata ◽  
Tadashi Okano ◽  
Hiromitsu Toyoda ◽  
Sonoe Mashino
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Lower Extremity ◽  
Physical Function ◽  
Community Dwelling ◽  
Group Exercise ◽  
Community Based ◽  
Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

scholarly journals Standard Value of Lower Extremity Muscle Strength of 8 Years Old Children and Its Correlation with Body Weight and Height

1970 ◽  
Vol 2 (01) ◽  
pp. 45-54
Author(s):  
Sarifitri FH Hutagalung ◽  
Ferial Hadipoetro Idris, ◽  
Keyword(s):  
Body Weight ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Body Height ◽  
Knee Extensor ◽  
Left Knee ◽  
Knee Flexor ◽  
Lower Extremity Muscle ◽  
Left Ankle ◽  
Hip Flexor

Objectives: to know the standard value of lower extremity muscle strength of eight year old children and furthermore to explore the correlation of the muscle strength and body height and weight.Methods: The study design is cross sectional. The target is eight year old children in public elementary school in Jakarta Pusat. The subjects’ characteristics are normal nutritional state, and no neurological normusculoskeletal disorders. Sampling was done by cluster randomization to determine the location and simple randomization on site to determine subjects. There were 171 boys and 180 girls in this tudy. Independentvariables are age, sex, body weight, body height and nutritional state that was determine with Z-score of body mass index. Dependent variables are lower extremity muscle strength that classify as torque. This study usedhand-held dynamometer for muscle strength measurement. Statistical analysis was done with descriptive statistic and Pearson and Spearman correlation test.Results: Standard values of eight year old boy’s lower extremity muscle strength are: right hip flexor 21.86 Nm (SD 3.40), left hip flexor 19.64 Nm (SD 3.19), right hip extensor 17.05 Nm (SD 3.66), left hip extensor16.08 Nm (SD 3.56), right knee extensor 18.19 Nm (SD 3.60), left knee extensor 16.09 Nm (SD 3.55), right knee flexor 15.18 Nm (SD 4.23), left knee flexor 14.48 Nm (SD 3.97), right ankle dorsiflexor 6.58 Nm (SD1.53), left ankle dorsiflexor 6.05 Nm (SD 1.42), right ankle plantarflexor 10.08 Nm (SD 1.69), left ankle plantar flexor 9.13 Nm (SD 1.90).Standard values of eight year old girl’s lower extremity muscle strength are: right hip flexor 21.60 Nm (SD 3.62), left hip flexor 19.62 Nm (SD 3.37), right hip extensor 16.66 Nm (SD 4.06), left hip extensor 15.81 Nm(SD 3.94), right knee extensor 17.43 Nm (SD 3.79), left knee extensor 15.20 Nm (SD 3.38), right knee flexor 14.61 Nm (SD 4.28), left knee flexor 13.51 Nm (SD 4.00), right ankle dorsiflexor 6.34 Nm (SD 1.45), leftankle dorsiflexor 5.97 Nm (SD 1.52), right ankle plantarflexor 9.55 Nm (SD 1.98), left ankle plantar flexor 8.69 Nm (SD 1.83). The boy’s lower extremity muscle strength are stronger than the girl’s in left knee extensor,left knee flexor, right ankle plantarflexor and left ankle plantarflexor. The boy’s muscle strength are moderately correlated to body height except for right hip extensor, left hip extensor and right ankle dorsiflexorthat weakly correlated. The boy’s muscle strength are moderately correlated to body weight except for left hip extensor that weakly correlated. The girl’s muscle strength are moderately correlated to body height. Thegirl’s muscle strength are moderately correlated to body weight except for left hip flexor and left hip extensor that weakly correlated.Conclusions: The muscle strength pattern of boys and girls is similar; the strongest are right hip flexor and the weakest are left ankle dorsiflexor.Keywords: Muscle strength, standard values of eight year old children, torque, hand-held dynamometer

Active vitamin D is cardioprotective in experimental uraemia but not in children with CKD Stages 3–5

2020 ◽  
Author(s):  
Anne Schön ◽  
Maren Leifheit-Nestler ◽  
Jennifer Deppe ◽  
Dagmar-Christiane Fischer ◽  
Aysun K Bayazit ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
Cardiac Remodelling ◽  
Study Cohort ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
Cardiac Phenotype

Abstract Background Uraemic cardiac remodelling is associated with vitamin D and Klotho deficiency, elevated fibroblast growth factor 23 (FGF23) and activation of the renin–angiotensin system (RAS). The cardioprotective properties of active vitamin D analogues in this setting are unclear. Methods In rats with 5/6 nephrectomy (5/6Nx) treated with calcitriol, the cardiac phenotype and local RAS activation were investigated compared with controls. A nested case–control study was performed within the Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) study, including children with chronic kidney disease (CKD) Stages 3–5 [estimated glomerular filtration rate (eGFR) 25 mL/min/1.73 m2] treated with and without active vitamin D. Echocardiograms, plasma FGF23 and soluble Klotho (sKlotho) were assessed at baseline and after 9 months. Results In rats with 5/6Nx, left ventricular (LV) hypertrophy, LV fibrosis and upregulated cardiac RAS were dose-dependently attenuated by calcitriol. Calcitriol further stimulated FGF23 synthesis in bone but not in the heart, and normalized suppressed renal Klotho expression. In the 4C study cohort, treatment over a mean period of 9 months with active vitamin D was associated with increased FGF23 and phosphate and decreased sKlotho and eGFR compared with vitamin D naïve controls, whereas LV mass index did not differ between groups. Conclusions Active vitamin D ameliorates cardiac remodelling and normalizes renal Klotho expression in 5/6Nx rats but does not improve the cardiac phenotype in children with CKD Stages 3–5. This discrepancy may be due to further enhancement of circulating FGF23 and faster progression of CKD associated with reduced sKlotho and higher serum phosphate in vitamin D-treated patients.

scholarly journals Prescribing quality in secondary care patients with different stages of chronic kidney disease: a retrospective study in the Netherlands

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025784 ◽  
Author(s):  
Kirsten PJ Smits ◽  
Grigory Sidorenkov ◽  
Frans J van Ittersum ◽  
Femke Waanders ◽  
Henk JG Bilo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Secondary Care ◽  
Phosphate Binders ◽  
Active Vitamin ◽  
Active Vitamin D ◽  
Prescribing Quality ◽  
Raas Inhibitors ◽  
To Receive

ObjectivesInsight in the prescribing quality for patients with chronic kidney disease (CKD) in secondary care is limited. The aim of this study is to assess the prescribing quality in secondary care patients with CKD stages 3–5 and possible differences in quality between CKD stages.DesignThis was a retrospective cohort study.SettingData were collected at two university (n=569 and n=845) and one non-university nephrology outpatient clinic (n=1718) in the Netherlands.ParticipantsBetween March 2015 and August 2016, data were collected from patients with stages 3a–5 CKD seen at the clinics. Blood pressure measurements, laboratory measurements and prescription data were extracted from medical records. For each prescribing quality indicator, patients with incomplete data required for calculation were excluded.Outcome measuresPotentially appropriate prescribing of antihypertensives, renin-angiotensin-aldosterone system (RAAS) inhibitors, statins, phosphate binders and potentially inappropriate prescribing according to prevailing guidelines was assessed using prescribing quality indicators. Χ2or Fisher’s exact tests were used to test for differences in prescribing quality.ResultsRAAS inhibitors alone or in combination with diuretics (57% or 52%, respectively) and statins (42%) were prescribed less often than phosphate binders (72%) or antihypertensives (94%) when indicated. Active vitamin D was relatively often prescribed when potentially not indicated (19%). Patients with high CKD stages were less likely to receive RAAS inhibitors but more likely to receive statins when indicated than stage 3 CKD patients. They also received more active vitamin D and erythropoietin-stimulating agents when potentially not indicated.ConclusionsPriority areas for improvement of prescribing in CKD outpatients include potential underprescribing of RAAS inhibitors and statins, and potential overprescribing of active vitamin D. CKD stage should be taken into account when assessing prescribing quality.

scholarly journals Treatment Failure of Active Vitamin D Therapy in Chronic Kidney Disease: Predictive Factors

2015 ◽  
Vol 42 (3) ◽  
pp. 228-236 ◽  
Author(s):  
Mario Cozzolino ◽  
Adrian Covic ◽  
Blanca Martinez-Placencia ◽  
Konstantinos Xynos
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Treatment Failure ◽  
Serum Levels ◽  
Clinical Effects ◽  
Active Vitamin ◽  
Ipth Level ◽  
Active Vitamin D ◽  
Vitamin D Levels

Background: In patients with chronic kidney disease (CKD), impaired renal function leads to decreased vitamin D levels, which causes an increase in parathyroid hormone (PTH) production and contributes to the development of secondary hyperparathyroidism (SHPT). This may result in adverse clinical effects such as bone disorders, vascular calcification, cardiovascular disease, and increased mortality. Current treatment practices and associated outcomes with active vitamin D treatment in patients with CKD were reviewed with the objective to assess parameters (such as PTH and serum calcium levels) that may be used to define the failure of vitamin D treatment. Summary: Reports based on observational data have noted improved outcomes with active vitamin D treatment (calcitriol, paricalcitol, alfacalcidol, or doxercalciferol) in patients with CKD. Criteria for the identification of active vitamin D treatment failure are unclear from current guidelines, although up to 50% of patients may experience treatment failure eventually because of development of hypercalcemia or resistant SHPT, characterized by an elevated intact PTH (iPTH) level despite treatment. We propose a definition of vitamin D treatment failure as iPTH >600 pg/ml after 6 months of intravenous active vitamin D treatment and corrected total calcium serum levels >10.2 mg/dl, and review factors that may predict the response to vitamin D treatment. Key Message: Active vitamin D treatment failure is an important challenge in clinical practice. The aim of the proposed definition is to suggest a possible framework for hypothesis generation and to encourage further research into this common problem.

Sign in / Sign up

Export Citation Format

Share Document