Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease
Background. Chronic renal replacement therapy patients exhibit reduction in skeletal muscle function as a result of a combination of metabolic effects and muscle fibre size reduction. The aim of this study was to compare muscle mass with function in patients with chronic kidney disease (CKD) at stag...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2006-08, Vol.21 (8), p.2210-2216 |
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| creator | McIntyre, Christopher W. Selby, Nicholas M. Sigrist, Mhairi Pearce, Lyndsay E. Mercer, Thomas H. Naish, Patrick F. |
| description | Background. Chronic renal replacement therapy patients exhibit reduction in skeletal muscle function as a result of a combination of metabolic effects and muscle fibre size reduction. The aim of this study was to compare muscle mass with function in patients with chronic kidney disease (CKD) at stages 4 and 5 on haemodialysis (HD) and peritoneal dialysis (PD), and investigate the associations of muscle wasting in a cross-sectional cohort. Methods. We studied 134 patients (60 HD, 28 PD and 46 CKD 4). The three groups were well matched for age, sex, diabetes and dialysis vintage. Cross-sectional area (CSA) of muscle and fat was measured from a standardized multi-slice CT scan of a 6 cm long section of thigh. CSA of soft tissue was taken from appropriate fat and muscle densities. Functional assessment was by the sit-to-stand 60 test, assessing both the number of sit-to-stands possible under controlled conditions in 60 s (STS 60), and the time taken to perform five sit-to-stand movements (STS 5). Data were collected on a wide range of potential determinants of muscle CSA. Results. There were no significant differences in haemoglobin between males or females or between any of the groups studied. Serum phosphate and calcium-phosphate product were higher in HD patients as compared to CKD4 patients, but there were no differences in these variables when comparing PD patients with either CKD4 or HD patients. Muscle CSA correlated well with objective functional assessments in males (STS 60 R = 0.52, P |
| doi_str_mv | 10.1093/ndt/gfl064 |
| format | Article |
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Chronic renal replacement therapy patients exhibit reduction in skeletal muscle function as a result of a combination of metabolic effects and muscle fibre size reduction. The aim of this study was to compare muscle mass with function in patients with chronic kidney disease (CKD) at stages 4 and 5 on haemodialysis (HD) and peritoneal dialysis (PD), and investigate the associations of muscle wasting in a cross-sectional cohort. Methods. We studied 134 patients (60 HD, 28 PD and 46 CKD 4). The three groups were well matched for age, sex, diabetes and dialysis vintage. Cross-sectional area (CSA) of muscle and fat was measured from a standardized multi-slice CT scan of a 6 cm long section of thigh. CSA of soft tissue was taken from appropriate fat and muscle densities. Functional assessment was by the sit-to-stand 60 test, assessing both the number of sit-to-stands possible under controlled conditions in 60 s (STS 60), and the time taken to perform five sit-to-stand movements (STS 5). Data were collected on a wide range of potential determinants of muscle CSA. Results. There were no significant differences in haemoglobin between males or females or between any of the groups studied. Serum phosphate and calcium-phosphate product were higher in HD patients as compared to CKD4 patients, but there were no differences in these variables when comparing PD patients with either CKD4 or HD patients. Muscle CSA correlated well with objective functional assessments in males (STS 60 R = 0.52, P<0.0001) and females (R = 0.41, P = 0.004), and STS performance was reduced in dialysed patients as compared with CKD 4. Univariate analysis demonstrated that muscle CSA was associated with serum albumin concentration (R = 0.49, P<0.0001), age (R = −0.35, P = 0.005) and C-reactive protein (R = −0.34, P = 0.004). Creatinine clearance, dialysis adequacy, dialysis vintage and time-averaged serum bicarbonate, calcium and phosphate concentrations were not correlated with muscle CSA. Conclusion. In conclusion, patients with dialysis-treated CKD 5 exhibited more functionally significant muscle wasting than patients with CKD 4. This may be amenable to modification with targeted exercise or amelioration of factors associated with observed differences in muscle mass.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfl064</identifier><identifier>PMID: 16504974</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adipose Tissue - diagnostic imaging ; Adipose Tissue - pathology ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anthropometry ; Bicarbonates - blood ; Biological and medical sciences ; Body Mass Index ; C-Reactive Protein - analysis ; Chronic Disease ; chronic kidney disease ; Cohort Studies ; Comorbidity ; computed tomography ; Cross-Sectional Studies ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Glomerulonephritis ; haemodialysis ; Hemoglobins - analysis ; Humans ; Intensive care medicine ; Kidney Diseases - complications ; Kidney Diseases - therapy ; Male ; Medical sciences ; Middle Aged ; Muscle, Skeletal - diagnostic imaging ; Muscle, Skeletal - pathology ; Muscular Atrophy - diagnostic imaging ; Muscular Atrophy - etiology ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; peritoneal dialysis ; Peritoneal Dialysis - adverse effects ; Phosphates - blood ; Renal Dialysis - adverse effects ; Serum Albumin - analysis ; Severity of Illness Index ; Single-Blind Method ; skeletal muscle ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Tomography, Spiral Computed ; Uremia - etiology ; Uremia - therapy ; wasting</subject><ispartof>Nephrology, dialysis, transplantation, 2006-08, Vol.21 (8), p.2210-2216</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Oxford Publishing Limited(England) Aug 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-43b39395d80191a2ca4581db0370c19ddbb55d43fe3d7192808d5f1f1496e9eb3</citedby><cites>FETCH-LOGICAL-c416t-43b39395d80191a2ca4581db0370c19ddbb55d43fe3d7192808d5f1f1496e9eb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18036059$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16504974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McIntyre, Christopher W.</creatorcontrib><creatorcontrib>Selby, Nicholas M.</creatorcontrib><creatorcontrib>Sigrist, Mhairi</creatorcontrib><creatorcontrib>Pearce, Lyndsay E.</creatorcontrib><creatorcontrib>Mercer, Thomas H.</creatorcontrib><creatorcontrib>Naish, Patrick F.</creatorcontrib><title>Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol. Dial. Transplant</addtitle><description>Background. Chronic renal replacement therapy patients exhibit reduction in skeletal muscle function as a result of a combination of metabolic effects and muscle fibre size reduction. The aim of this study was to compare muscle mass with function in patients with chronic kidney disease (CKD) at stages 4 and 5 on haemodialysis (HD) and peritoneal dialysis (PD), and investigate the associations of muscle wasting in a cross-sectional cohort. Methods. We studied 134 patients (60 HD, 28 PD and 46 CKD 4). The three groups were well matched for age, sex, diabetes and dialysis vintage. Cross-sectional area (CSA) of muscle and fat was measured from a standardized multi-slice CT scan of a 6 cm long section of thigh. CSA of soft tissue was taken from appropriate fat and muscle densities. Functional assessment was by the sit-to-stand 60 test, assessing both the number of sit-to-stands possible under controlled conditions in 60 s (STS 60), and the time taken to perform five sit-to-stand movements (STS 5). Data were collected on a wide range of potential determinants of muscle CSA. Results. There were no significant differences in haemoglobin between males or females or between any of the groups studied. Serum phosphate and calcium-phosphate product were higher in HD patients as compared to CKD4 patients, but there were no differences in these variables when comparing PD patients with either CKD4 or HD patients. Muscle CSA correlated well with objective functional assessments in males (STS 60 R = 0.52, P<0.0001) and females (R = 0.41, P = 0.004), and STS performance was reduced in dialysed patients as compared with CKD 4. Univariate analysis demonstrated that muscle CSA was associated with serum albumin concentration (R = 0.49, P<0.0001), age (R = −0.35, P = 0.005) and C-reactive protein (R = −0.34, P = 0.004). Creatinine clearance, dialysis adequacy, dialysis vintage and time-averaged serum bicarbonate, calcium and phosphate concentrations were not correlated with muscle CSA. Conclusion. In conclusion, patients with dialysis-treated CKD 5 exhibited more functionally significant muscle wasting than patients with CKD 4. This may be amenable to modification with targeted exercise or amelioration of factors associated with observed differences in muscle mass.</description><subject>Adipose Tissue - diagnostic imaging</subject><subject>Adipose Tissue - pathology</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anthropometry</subject><subject>Bicarbonates - blood</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>C-Reactive Protein - analysis</subject><subject>Chronic Disease</subject><subject>chronic kidney disease</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>computed tomography</subject><subject>Cross-Sectional Studies</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Glomerulonephritis</subject><subject>haemodialysis</subject><subject>Hemoglobins - analysis</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Kidney Diseases - complications</subject><subject>Kidney Diseases - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Muscle, Skeletal - diagnostic imaging</subject><subject>Muscle, Skeletal - pathology</subject><subject>Muscular Atrophy - diagnostic imaging</subject><subject>Muscular Atrophy - etiology</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>peritoneal dialysis</subject><subject>Peritoneal Dialysis - adverse effects</subject><subject>Phosphates - blood</subject><subject>Renal Dialysis - adverse effects</subject><subject>Serum Albumin - analysis</subject><subject>Severity of Illness Index</subject><subject>Single-Blind Method</subject><subject>skeletal muscle</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Tomography, Spiral Computed</subject><subject>Uremia - etiology</subject><subject>Uremia - therapy</subject><subject>wasting</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0V1rFDEUBuBBFLtWb_wBEgS9EMYmk4-ZXJb6UbFgBQXxJmSSM7vpZjJrktm6_8ifaZZdW_Am5-I8eQN5q-o5wW8JlvQs2Hy2HDwW7EG1IEzguqEdf1gtypLUmGN5Uj1J6QZjLJu2fVydEMExky1bVH-udXYQckIRDLitC0s0ahcyBB0MIOu03yWX0EpvAY1TBJRgC2UMczDZTUF7v0PJLYMbnNEho7QGD1l7NM7JeEC3OuV9bF7pgDb_nrt1eXWXXrtgYQPlKPfNKk7BGbR2NsCumAQ6wdPq0aB9gmfHeVp9__D-28VlffXl46eL86vaMCJyzWhPJZXcdphIohujGe-I7TFtsSHS2r7n3DI6ALUtkU2HO8sHMhAmBUjo6Wn1-pC7idOvGVJWo0sGvNcBpjkp0YlWUNYW-PI_eDPNsXxHUg3pCGeS7NGbAzJxSinCoDbRjTruFMFqX54q5alDeQW_OCbO_Qj2nh7bKuDVEehktB9iqcile9dhKjCXxdUH51KG33d7HddKtLTl6vLHT8XFNW8-v2vVV_oXoSK2rg</recordid><startdate>20060801</startdate><enddate>20060801</enddate><creator>McIntyre, Christopher W.</creator><creator>Selby, Nicholas M.</creator><creator>Sigrist, Mhairi</creator><creator>Pearce, Lyndsay E.</creator><creator>Mercer, Thomas H.</creator><creator>Naish, Patrick F.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><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>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20060801</creationdate><title>Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease</title><author>McIntyre, Christopher W. ; Selby, Nicholas M. ; Sigrist, Mhairi ; Pearce, Lyndsay E. ; Mercer, Thomas H. ; Naish, Patrick F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-43b39395d80191a2ca4581db0370c19ddbb55d43fe3d7192808d5f1f1496e9eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adipose Tissue - diagnostic imaging</topic><topic>Adipose Tissue - pathology</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anthropometry</topic><topic>Bicarbonates - blood</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>C-Reactive Protein - analysis</topic><topic>Chronic Disease</topic><topic>chronic kidney disease</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>computed tomography</topic><topic>Cross-Sectional Studies</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Glomerulonephritis</topic><topic>haemodialysis</topic><topic>Hemoglobins - analysis</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Kidney Diseases - complications</topic><topic>Kidney Diseases - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Muscle, Skeletal - diagnostic imaging</topic><topic>Muscle, Skeletal - pathology</topic><topic>Muscular Atrophy - diagnostic imaging</topic><topic>Muscular Atrophy - etiology</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>peritoneal dialysis</topic><topic>Peritoneal Dialysis - adverse effects</topic><topic>Phosphates - blood</topic><topic>Renal Dialysis - adverse effects</topic><topic>Serum Albumin - analysis</topic><topic>Severity of Illness Index</topic><topic>Single-Blind Method</topic><topic>skeletal muscle</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Tomography, Spiral Computed</topic><topic>Uremia - etiology</topic><topic>Uremia - therapy</topic><topic>wasting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McIntyre, Christopher W.</creatorcontrib><creatorcontrib>Selby, Nicholas M.</creatorcontrib><creatorcontrib>Sigrist, Mhairi</creatorcontrib><creatorcontrib>Pearce, Lyndsay E.</creatorcontrib><creatorcontrib>Mercer, Thomas H.</creatorcontrib><creatorcontrib>Naish, Patrick F.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McIntyre, Christopher W.</au><au>Selby, Nicholas M.</au><au>Sigrist, Mhairi</au><au>Pearce, Lyndsay E.</au><au>Mercer, Thomas H.</au><au>Naish, Patrick F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol. Dial. Transplant</addtitle><date>2006-08-01</date><risdate>2006</risdate><volume>21</volume><issue>8</issue><spage>2210</spage><epage>2216</epage><pages>2210-2216</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background. Chronic renal replacement therapy patients exhibit reduction in skeletal muscle function as a result of a combination of metabolic effects and muscle fibre size reduction. The aim of this study was to compare muscle mass with function in patients with chronic kidney disease (CKD) at stages 4 and 5 on haemodialysis (HD) and peritoneal dialysis (PD), and investigate the associations of muscle wasting in a cross-sectional cohort. Methods. We studied 134 patients (60 HD, 28 PD and 46 CKD 4). The three groups were well matched for age, sex, diabetes and dialysis vintage. Cross-sectional area (CSA) of muscle and fat was measured from a standardized multi-slice CT scan of a 6 cm long section of thigh. CSA of soft tissue was taken from appropriate fat and muscle densities. Functional assessment was by the sit-to-stand 60 test, assessing both the number of sit-to-stands possible under controlled conditions in 60 s (STS 60), and the time taken to perform five sit-to-stand movements (STS 5). Data were collected on a wide range of potential determinants of muscle CSA. Results. There were no significant differences in haemoglobin between males or females or between any of the groups studied. Serum phosphate and calcium-phosphate product were higher in HD patients as compared to CKD4 patients, but there were no differences in these variables when comparing PD patients with either CKD4 or HD patients. Muscle CSA correlated well with objective functional assessments in males (STS 60 R = 0.52, P<0.0001) and females (R = 0.41, P = 0.004), and STS performance was reduced in dialysed patients as compared with CKD 4. Univariate analysis demonstrated that muscle CSA was associated with serum albumin concentration (R = 0.49, P<0.0001), age (R = −0.35, P = 0.005) and C-reactive protein (R = −0.34, P = 0.004). Creatinine clearance, dialysis adequacy, dialysis vintage and time-averaged serum bicarbonate, calcium and phosphate concentrations were not correlated with muscle CSA. Conclusion. In conclusion, patients with dialysis-treated CKD 5 exhibited more functionally significant muscle wasting than patients with CKD 4. This may be amenable to modification with targeted exercise or amelioration of factors associated with observed differences in muscle mass.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16504974</pmid><doi>10.1093/ndt/gfl064</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Nephrology, dialysis, transplantation, 2006-08, Vol.21 (8), p.2210-2216 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adipose Tissue - diagnostic imaging Adipose Tissue - pathology Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anthropometry Bicarbonates - blood Biological and medical sciences Body Mass Index C-Reactive Protein - analysis Chronic Disease chronic kidney disease Cohort Studies Comorbidity computed tomography Cross-Sectional Studies Emergency and intensive care: renal failure. Dialysis management Female Glomerulonephritis haemodialysis Hemoglobins - analysis Humans Intensive care medicine Kidney Diseases - complications Kidney Diseases - therapy Male Medical sciences Middle Aged Muscle, Skeletal - diagnostic imaging Muscle, Skeletal - pathology Muscular Atrophy - diagnostic imaging Muscular Atrophy - etiology Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure peritoneal dialysis Peritoneal Dialysis - adverse effects Phosphates - blood Renal Dialysis - adverse effects Serum Albumin - analysis Severity of Illness Index Single-Blind Method skeletal muscle Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Tomography, Spiral Computed Uremia - etiology Uremia - therapy wasting |
| title | Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease |
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