Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Christopher W McIntyrePatrick F Naish

Abstract

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. 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. 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 pat...Continue Reading

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