Natural history of skeletal muscle mass changes in chronic kidney disease stage 4 and 5 patients: an observational study
Cross-sectional studies in dialysis demonstrate muscle wasting associated with loss of function, increased morbidity and mortality. The relative drivers are poorly understood. There is a paucity of data regarding interval change in muscle in pre-dialysis and dialysis-dependant patients. This study a...
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| description | Cross-sectional studies in dialysis demonstrate muscle wasting associated with loss of function, increased morbidity and mortality. The relative drivers are poorly understood. There is a paucity of data regarding interval change in muscle in pre-dialysis and dialysis-dependant patients. This study aimed to examine muscle and fat mass change and elucidate associations with muscle wasting in advanced CKD. 134 patients were studied (60 HD, 28 PD, 46 CKD 4-5) and followed up for two years. Groups were similar in age, sex and diabetes prevalence. Soft tissue cross-sectional area (CSA) was measured annually on 3 occasions by a standardised multi-slice CT thigh. Potential determinants of muscle and fat CSA were assessed. Functional ability was assessed by sit-to-stand testing. 88 patients completed follow-up (40 HD, 16 PD, 32 CKD). There was a significant difference in percentage change in muscle CSA (MCSA) over year 1, dependant on treatment modality (χ(2) = 6.46; p = 0.039). Muscle loss was most pronounced in pre-dialysis patients. Muscle loss during year 1 was partially reversed in year 2 in 39%. Incident dialysis patients significantly lost MCSA during the year which they commenced dialysis, but not the subsequent year. Baseline MCSA, change in MCSA during year 1 and dialysis modality predicted year 2 change in MCSA (adjusted R(2) = 0.77, p |
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The relative drivers are poorly understood. There is a paucity of data regarding interval change in muscle in pre-dialysis and dialysis-dependant patients. This study aimed to examine muscle and fat mass change and elucidate associations with muscle wasting in advanced CKD. 134 patients were studied (60 HD, 28 PD, 46 CKD 4-5) and followed up for two years. Groups were similar in age, sex and diabetes prevalence. Soft tissue cross-sectional area (CSA) was measured annually on 3 occasions by a standardised multi-slice CT thigh. Potential determinants of muscle and fat CSA were assessed. Functional ability was assessed by sit-to-stand testing. 88 patients completed follow-up (40 HD, 16 PD, 32 CKD). There was a significant difference in percentage change in muscle CSA (MCSA) over year 1, dependant on treatment modality (χ(2) = 6.46; p = 0.039). Muscle loss was most pronounced in pre-dialysis patients. Muscle loss during year 1 was partially reversed in year 2 in 39%. Incident dialysis patients significantly lost MCSA during the year which they commenced dialysis, but not the subsequent year. Baseline MCSA, change in MCSA during year 1 and dialysis modality predicted year 2 change in MCSA (adjusted R(2) = 0.77, p<0.001). There was no correlation between muscle or fat CSA change and any other factors. MCSA correlated with functional testing, although MCSA change correlated poorly with change in functional ability. These data demonstrate marked variability in MCSA over 2 years. Loss of MCSA in both pre-dialysis and established dialysis patients is reversible. Factors previously cross-sectionally shown to correlate with MCSA did not correlate with wasting progression. The higher rate of muscle loss in undialysed CKD patients, and its reversal after dialysis commencement, suggests that conventional indicators may not result in optimal timing of dialysis initiation.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0065372</identifier><identifier>PMID: 23741490</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adipose Tissue - pathology ; Age ; Aged ; Body fat ; Correlation ; Cross-Sectional Studies ; Diabetes ; Diabetes mellitus ; Dialysis ; Exercise ; Female ; Fitness training programs ; Follow-Up Studies ; Functional testing ; Hospitals ; Humans ; Inflammation ; Insulin resistance ; Kidney diseases ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - pathology ; Kidney Failure, Chronic - therapy ; Kidney transplantation ; Male ; Medical imaging ; Medicine ; Middle Aged ; Morbidity ; Mortality ; Muscle function ; Muscle, Skeletal - pathology ; Muscle, Skeletal - physiopathology ; Muscles ; Muscular Atrophy - etiology ; Muscular Atrophy - physiopathology ; Observational studies ; Organ Size ; Patients ; Peritoneal dialysis ; Proteins ; Renal Dialysis ; Rodents ; Skeletal muscle ; Strength training ; Thigh ; Tomography ; Transplants & implants</subject><ispartof>PloS one, 2013-05, Vol.8 (5), p.e65372-e65372</ispartof><rights>2013 John et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 John et al 2013 John et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c592t-e35194a54d255a328b74601f753ae291c80fabfb2deb85e7c6c333195e51cb8d3</citedby><cites>FETCH-LOGICAL-c592t-e35194a54d255a328b74601f753ae291c80fabfb2deb85e7c6c333195e51cb8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669290/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669290/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23741490$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>John, Stephen G</creatorcontrib><creatorcontrib>Sigrist, Mhairi K</creatorcontrib><creatorcontrib>Taal, Maarten W</creatorcontrib><creatorcontrib>McIntyre, Christopher W</creatorcontrib><title>Natural history of skeletal muscle mass changes in chronic kidney disease stage 4 and 5 patients: an observational study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Cross-sectional studies in dialysis demonstrate muscle wasting associated with loss of function, increased morbidity and mortality. The relative drivers are poorly understood. There is a paucity of data regarding interval change in muscle in pre-dialysis and dialysis-dependant patients. This study aimed to examine muscle and fat mass change and elucidate associations with muscle wasting in advanced CKD. 134 patients were studied (60 HD, 28 PD, 46 CKD 4-5) and followed up for two years. Groups were similar in age, sex and diabetes prevalence. Soft tissue cross-sectional area (CSA) was measured annually on 3 occasions by a standardised multi-slice CT thigh. Potential determinants of muscle and fat CSA were assessed. Functional ability was assessed by sit-to-stand testing. 88 patients completed follow-up (40 HD, 16 PD, 32 CKD). There was a significant difference in percentage change in muscle CSA (MCSA) over year 1, dependant on treatment modality (χ(2) = 6.46; p = 0.039). Muscle loss was most pronounced in pre-dialysis patients. Muscle loss during year 1 was partially reversed in year 2 in 39%. Incident dialysis patients significantly lost MCSA during the year which they commenced dialysis, but not the subsequent year. Baseline MCSA, change in MCSA during year 1 and dialysis modality predicted year 2 change in MCSA (adjusted R(2) = 0.77, p<0.001). There was no correlation between muscle or fat CSA change and any other factors. MCSA correlated with functional testing, although MCSA change correlated poorly with change in functional ability. These data demonstrate marked variability in MCSA over 2 years. Loss of MCSA in both pre-dialysis and established dialysis patients is reversible. Factors previously cross-sectionally shown to correlate with MCSA did not correlate with wasting progression. The higher rate of muscle loss in undialysed CKD patients, and its reversal after dialysis commencement, suggests that conventional indicators may not result in optimal timing of dialysis initiation.</description><subject>Adipose Tissue - pathology</subject><subject>Age</subject><subject>Aged</subject><subject>Body fat</subject><subject>Correlation</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Dialysis</subject><subject>Exercise</subject><subject>Female</subject><subject>Fitness training programs</subject><subject>Follow-Up Studies</subject><subject>Functional testing</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Insulin resistance</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - pathology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Kidney transplantation</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Muscle function</subject><subject>Muscle, Skeletal - pathology</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Muscles</subject><subject>Muscular Atrophy - etiology</subject><subject>Muscular Atrophy - physiopathology</subject><subject>Observational studies</subject><subject>Organ Size</subject><subject>Patients</subject><subject>Peritoneal dialysis</subject><subject>Proteins</subject><subject>Renal Dialysis</subject><subject>Rodents</subject><subject>Skeletal muscle</subject><subject>Strength training</subject><subject>Thigh</subject><subject>Tomography</subject><subject>Transplants & implants</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1v1DAQjRCIlsI_QGCJSy-7-Dsxh0qoKlCpggucrYk92fU2Gy92UrH_HrebVi3i5PHzm-eZp1dVbxldMlGzj5s4pQH65S4OuKRUK1HzZ9UxM4IvNKfi-aP6qHqV84ZSJRqtX1ZHXNSSSUOPqz_fYZwS9GQd8hjTnsSO5GvscSzYdsquR7KFnIlbw7DCTMJQyhSH4Mh18APuiQ8ZISPJI6yQSAKDJ4rsYAw4jPlTuZPYZkw3BYll4kKc_P519aKDPuOb-Typfn25-Hn-bXH14-vl-eerhVOGjwsUihkJSnquFAjetLXUlHW1EoDcMNfQDtqu5R7bRmHttBNCMKNQMdc2XpxU7w-6uz5mO5uWLRPFF8N1Iwrj8sDwETZ2l8IW0t5GCPYOiGllIY2hOGFVaxoKwvNOovS6MV52QkiOCgxyLYvW2fzb1G7Ru-JAMfeJ6NOXIaztKt5YobXhhhaB01kgxd8T5tFuQ3bY9zBgnO7mVqapa2MK9cM_1P9vJw8sl2LOCbuHYRi1t0G677K3QbJzkErbu8eLPDTdJ0f8BSlzx9k</recordid><startdate>20130531</startdate><enddate>20130531</enddate><creator>John, Stephen G</creator><creator>Sigrist, Mhairi K</creator><creator>Taal, Maarten W</creator><creator>McIntyre, Christopher W</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130531</creationdate><title>Natural history of skeletal muscle mass changes in chronic kidney disease stage 4 and 5 patients: an observational study</title><author>John, Stephen G ; Sigrist, Mhairi K ; Taal, Maarten W ; McIntyre, Christopher W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c592t-e35194a54d255a328b74601f753ae291c80fabfb2deb85e7c6c333195e51cb8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adipose Tissue - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>John, Stephen G</au><au>Sigrist, Mhairi K</au><au>Taal, Maarten W</au><au>McIntyre, Christopher W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Natural history of skeletal muscle mass changes in chronic kidney disease stage 4 and 5 patients: an observational study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-05-31</date><risdate>2013</risdate><volume>8</volume><issue>5</issue><spage>e65372</spage><epage>e65372</epage><pages>e65372-e65372</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cross-sectional studies in dialysis demonstrate muscle wasting associated with loss of function, increased morbidity and mortality. The relative drivers are poorly understood. There is a paucity of data regarding interval change in muscle in pre-dialysis and dialysis-dependant patients. This study aimed to examine muscle and fat mass change and elucidate associations with muscle wasting in advanced CKD. 134 patients were studied (60 HD, 28 PD, 46 CKD 4-5) and followed up for two years. Groups were similar in age, sex and diabetes prevalence. Soft tissue cross-sectional area (CSA) was measured annually on 3 occasions by a standardised multi-slice CT thigh. Potential determinants of muscle and fat CSA were assessed. Functional ability was assessed by sit-to-stand testing. 88 patients completed follow-up (40 HD, 16 PD, 32 CKD). There was a significant difference in percentage change in muscle CSA (MCSA) over year 1, dependant on treatment modality (χ(2) = 6.46; p = 0.039). Muscle loss was most pronounced in pre-dialysis patients. Muscle loss during year 1 was partially reversed in year 2 in 39%. Incident dialysis patients significantly lost MCSA during the year which they commenced dialysis, but not the subsequent year. Baseline MCSA, change in MCSA during year 1 and dialysis modality predicted year 2 change in MCSA (adjusted R(2) = 0.77, p<0.001). There was no correlation between muscle or fat CSA change and any other factors. MCSA correlated with functional testing, although MCSA change correlated poorly with change in functional ability. These data demonstrate marked variability in MCSA over 2 years. Loss of MCSA in both pre-dialysis and established dialysis patients is reversible. Factors previously cross-sectionally shown to correlate with MCSA did not correlate with wasting progression. The higher rate of muscle loss in undialysed CKD patients, and its reversal after dialysis commencement, suggests that conventional indicators may not result in optimal timing of dialysis initiation.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23741490</pmid><doi>10.1371/journal.pone.0065372</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adipose Tissue - pathology Age Aged Body fat Correlation Cross-Sectional Studies Diabetes Diabetes mellitus Dialysis Exercise Female Fitness training programs Follow-Up Studies Functional testing Hospitals Humans Inflammation Insulin resistance Kidney diseases Kidney Failure, Chronic - complications Kidney Failure, Chronic - pathology Kidney Failure, Chronic - therapy Kidney transplantation Male Medical imaging Medicine Middle Aged Morbidity Mortality Muscle function Muscle, Skeletal - pathology Muscle, Skeletal - physiopathology Muscles Muscular Atrophy - etiology Muscular Atrophy - physiopathology Observational studies Organ Size Patients Peritoneal dialysis Proteins Renal Dialysis Rodents Skeletal muscle Strength training Thigh Tomography Transplants & implants |
| title | Natural history of skeletal muscle mass changes in chronic kidney disease stage 4 and 5 patients: an observational study |
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