Rafael Moreno-Gonzalez 1 , Xavier Corbella 1 , 2 , Francesco Mattace-Raso 3 , Lisanne Tap 3 , Cornel Sieber 4 , Ellen Freiberger 4 , Tomasz Kostka 5 , Agnieszka Guligowska 5 , Itshak Melzer 6 , Yehudit Melzer 6 , 7 , Axel C. Carlsson 8 , 9 , Johan Ärnlöv 8 , 9 , 10 , Regina Roller-Wirnsberger 11 , Gerhard Wirnsberger 11 , Pedro Gil 12 , Sara Lainez Martinez 12 , Paolo Fabbietti 13 , Andrea Corsonello , 13 , 14 , Fabrizia Lattanzio 14 , Francesc Formiga 1 , on behalf of SCOPE investigators
2 October 2020
Loss of muscle mass and function may be more pronounced in older adults with chronic kidney disease (CKD) and with albuminuria. Thus, we investigated the prevalence of sarcopenia among community-dwelling older adults according to kidney function and grade of albuminuria. We also explored differences in the prevalence of sarcopenia according to three different equations for the estimation of glomerular filtration rate (eGFR).
A cross-sectional analysis of 1420 community-dwelling older adults (≥75 years old) included in the SCOPE study, a multicenter prospective cohort study, was conducted. Comprehensive geriatric assessment including short physical performance battery (SPPB), handgrip strength test and bioelectrical impedance analysis (BIA) was performed. Sarcopenia was defined using the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). eGFR was calculated using Berlin Initiative Study (BIS), Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and Full Age Spectrum (FAS) equations, and urinary albumin-to-creatinine ratio (ACR) was collected to categorize CKD according to Kidney Disease Improving Global Outcomes guidelines.
Median age was 79.5 years (77.0–83.0), 804 (56.6%) were women. Using EWGSOP2 definition, 150 (10.6%) participants met diagnostic criteria for sarcopenia. Moreover, 85 (6%) participants had severe sarcopenia. Sarcopenia was more prevalent in participants with more advanced stages of CKD according to BIS eq. (9.6% in stages 1 and 2 and 13.9% in stages 3a, 3b and 4, p = 0.042), and also according to CKD-EPI (9.8% vs. 14.2%, p = 0.042) and FAS although not reaching statistical signification (9.8% vs. 12.7%, p = 0.119). Thus, differences in prevalence are observed among CKD categories as estimated by different equations. Prevalence of sarcopenia was also higher with increasing albuminuria categories: 9.3% in normoalbuminuric, 13.2% in microalbuminuric and 16.8% in macroalbuminuric participants, ( p = 0.019).