Factors Related to Osteosarcopenia in Kidney Transplant Recipients.

INTRODUCTION: Sarcopenia and osteopenia are highly prevalent in older patients, and are associated with a high risk for falls, fractures, and further functional decline. However, related factors in kidney transplant recipients suffering from osteosarcopenia, the combination of sarcopenia and osteopenia, remain unknown. MATERIAL AND METHODS: Fifty-eight transplant recipients (42 men and 16 women), with a mean age of 46.6 ± 12.7 years, were enrolled in this study. Sarcopenia was diagnosed according to the criteria of the Asia Working Group for Sarcopenia. Osteopenia was diagnosed according to World Health Organization criteria using bone mineral density (BMD) of the lumbar spine. Patients who met the diagnostic criteria of both diseases were defined as having osteosarcopenia. RESULTS: Ten patients had osteosarcopenia. According to univariate analyses, there were significant differences between osteosarcopenia group and non osteosarcopenia group in age (P = .002), duration of dialysis (P = .013), vitamin D levels (P = .002), and MET (P = .007). There was a significant positive correlation between vitamin D level and MET (r = .464; P < .001). The results of the multivariate analysis indicated that only MET was a relevant factor in osteosarcopenia. CONCLUSION: Duration of dialysis, low vitamin D levels, and physical activity after kidney transplantation were related to osteosarcopenia. These results suggested that osteosarcopenia in kidney transplant recipients is a carryover from the dialysis period.

Dual Energy X-ray Absorptiometry and Bioimpedance Analysis are Clinically Useful for Measuring Muscle Mass in Kidney Transplant Recipients With Sarcopenia.

PURPOSE: Computed tomography (CT) is considered the gold standard method for the diagnosis and characterization of sarcopenia. The aim of the present study was to determine the correlation between the volume of psoas muscle measured using CT and the measurement of muscle mass with dual energy X-ray absorptiometry (DXA) and bioimpedance analysis (BIA) in kidney transplant recipients. METHODS: Fifty-eight recipients (42 males and 16 females) were enrolled. Diagnostic criteria for sarcopenia were according to those of the Asia Working Group for Sarcopenia. The volume of psoas muscle was extracted using image recognition software from three-dimensional CT images. RESULTS: The volume of psoas muscle was 227.2 ± 61.3 mL in Group 1 (sarcopenia), 283.9 ± 75.3 mL in Group 2 (presarcopenia), and 363.7 ± 138.0 mL in Group 3 (without sarcopenia). Muscle mass measured using DXA was 15.80 ± 3.19 kg in Group 1, 16.36 ± 2.49 kg in Group 2, and 21.21 ± 4.14 kg in Group 3. Additionally, muscle mass assessed using BIA was 17.22 ± 4.11 kg in Group 1, 17.86 ± 3.30 kg in Group 2, and 21.48 ± 5.39 kg in Group 3. There were significant differences in the mean volume of psoas muscle between the 3 groups. There was a significant positive correlation between the volume of psoas muscle and the muscle mass assessed using DXA (r = 0.797; P < .001) and BIA (r = 0.761; P < .001). Furthermore, there was a significant positive correlation between DXA and BIA (r = 0.900; P < .001). CONCLUSIONS: It was suggested that estimating muscle mass using DXA and BIA is a preferred method for diagnosis of sarcopenia in kidney transplant recipients.

Factors Associated With the Development of Sarcopenia in Kidney Transplant Recipients.

INTRODUCTION: Sarcopenia is characterized by an involuntary loss of skeletal muscle mass, strength, and function. Previous studies suggest that it is generally associated with aging and chronic kidney diseases. The focus of this study was on the association between sarcopenia and pre-sarcopenia in kidney transplant recipients. METHODS: Fifty-one patients who underwent kidney transplantation at Kansai Medical University Hospital were enrolled, and their sarcopenia status was evaluated between April and July 2016. Sarcopenia was defined according to the criteria for the Asia Working Group for Sarcopenia. Skeletal muscle mass index was measured by using dual-energy radiograph absorptiometry; the cutoff points were <7.0 kg/m2 for male subjects and <5.4 kg/m2 for female subjects. For hand grip strength, values <26 kg (male subjects) and <17 kg (female subjects) was judged as sarcopenia. In both sexes, the cutoff point for walking speed was <0.8 m/s. RESULTS: Fifty-one recipients (36 men and 15 women) who met the inclusion criteria were enrolled in the study. The mean age of the recipients was 46.2 ± 12.8 years, and the mean duration of dialysis was 2.72 ± 3.61 years. Overall, 6 recipients (11.8%) had sarcopenia, and 25 recipients (49.0%) had pre-sarcopenia; 20 (39.2%) did not have sarcopenia. There were significant differences in age, duration of dialysis, body mass index, and triglyceride levels between the subgroups of recipients with and without sarcopenia. Multivariate regression analysis showed that age and duration of dialysis were independent variables for sarcopenic status. CONCLUSIONS: Our observations indicate that age and duration of dialysis before transplantation were independent determinants of sarcopenia and pre-sarcopenia in these kidney transplant recipients.