Dr Limy Wong1,2, Ms Dao Nguyen1, Ms Jennifer Howard1, Professor Lawrence P. McMahon1,2
1Department of Renal Medicine, Eastern Health, Box Hill, Australia, 2Department of Renal Medicine, Monash University Eastern Health Clinical School, Box Hill, Australia
Aim: To determine the relationship between sarcopenia and frailty in patients with chronic kidney disease (CKD).
Background: Sarcopenia is defined as loss of muscle mass, strength and/or performance while frailty is a syndrome characterised by a reduction in functional reserve, with an increased risk of developing adverse outcomes upon exposure to stressors. Both sarcopenia and frailty are strongly associated with all-cause mortality. However, no study has assessed the coexistence of sarcopenia and frailty in CKD patients.
Methods: A single institution cross-sectional study was performed. Sarcopenia and frailty were assessed according to the standard diagnostic criteria. Sensitivity and specificity using sarcopenia as a predictor of frailty were calculated. Logistic regression was performed to assess the relationship between sarcopenia and frailty.
Results: Twenty-one healthy controls (mean age 42.0±13.1 years), 26 CKD patients with estimated glomerular filtration rate between 15-90 ml/min/1.73m² (mean age 68.9±12.9 years) and 45 dialysis-dependent patients (mean age 67.4±17.0 years) were included. None of the healthy control subjects were sarcopenic though one (4.7%) was frail. Four (15.4%) CKD patients had sarcopenia and 4 (15.4%) were frail; while 25 (55.6%) patients who were dialysis-dependent had sarcopenia and 18 (40.0%) were frail. The prevalence of frailty among those with sarcopenia was 58.6%; whereas the prevalence of sarcopenia among frail people was 73.9%. Sarcopenia showed a moderate sensitivity (73.9%) but a higher specificity (82.6%) for the diagnosis of frailty, with a negative predictive value of 90.5%. Using multivariate logistic regression (adjusted for age, gender, diabetes and CKD), sarcopenia was significantly associated with frailty (OR=5.88, 95% CI=1.41, 31.5).
Conclusions: The absence of sarcopenia might be useful to exclude frailty but has limited utility as a biomarker of frailty.
Biography:
Limy Wong is a Nephrologist and Postdoctoral Fellow at Eastern Health. She graduated with First Class Honours in Medicine from the Royal College of Surgeons in Ireland and completed Nephrology specialist training in Ireland and the UK, gaining the Specialty Certificate in Nephrology from the Royal College of Physicians. She completed a Wellcome Trust Clinical PhD Fellowship at the University of Cambridge, studying the genetics of ANCA-associated vasculitis. She was recently awarded the 2021 and 2022 RACP Jacquot Research Establishment Fellowship, to conduct basic science and translational research to answer the questions surrounding the pathogenesis of sarcopenia in CKD patients.