Changes in Bone Mineral Density in Patients With Non-dialysis-Dependent Chronic Kidney Disease Are Associated With Body Composition.

OBJECTIVE: Chronic kidney disease (CKD) and low bone mineral density (BMD) are highly prevalent and can co-exist. Parameters of mineral metabolism are associated with BMD in CKD, but other contributing factors may contribute. The aim of this study was to assess changes in BMD and its determinants in patients with nondialysis-dependent CKD (NDD-CKD). METHODS: Body composition and biochemical profiles were assessed in a retrospective hospital-based cohort study of patients with NDD-CKD. BMD, lean soft tissue (LST), appendicular LST (ALST), and percentage fat mass were assessed by dual-energy X-ray absorptiometry. The ALST index (ALSTI, ALST/height2) and load-capacity index (LCI, fat mass/LST) were calculated. Low BMD was defined as T-score ≤ -1.0. RESULTS: The mean time between assessments was 2.8 ± 1.3 years; 46 patients were included. A reduction in renal function was observed. Changes in body composition included reductions in ALST (P = .031), ALSTI (P = .021), a trend for BMD (P = .053), and an increase in percentage fat mass (P = .044) and LCI (P = .032). Females had a reduction in BMD (P = .034), ALST (P = .026), and ALSTI (P = .037). Patients with low BMD at baseline had lower LST (P = .013), ALST (P = .023), and percentage fat mass (P = .037) than those with normal BMD. Additionally, reductions in LST (P = .041), ALST (P = .006), and ALSTI (P = .008) were observed in patients who had low BMD at baseline, while no significant changes in body composition were observed in those with normal BMD at baseline. The following body composition parameters at baseline were determinants of BMD status at follow-up: LST (odds ratio [OR]: 0.899, 95% confidence interval [CI]: 0.829-0.976, P = .010), ALST (OR: 0.825, 95% CI: 0.704-0.967, P = .017), and ALSTI (OR: 0.586, 95% CI: 0.354-0.968, P = .037), independent of fat mass and LCI. CONCLUSIONS: Detrimental body composition changes were observed without changes in body weight; these were more significant in females. Moreover, this is the first longitudinal study showing a protective effect of LST against BMD loss in patients with NDD-CKD.

A novel simulated media system for in vitro evaluation of bioequivalent intestinal drug solubility.

Orally administered solid drug must dissolve in the gastrointestinal tract before absorption to provide a systemic response. Intestinal solubility is therefore crucial but difficult to measure since human intestinal fluid (HIF) is challenging to obtain, varies between fasted (Fa) and fed (Fe) states and exhibits inter and intra subject variability. A single simulated intestinal fluid (SIF) cannot reflect HIF variability, therefore current approaches are not optimal. In this study we have compared literature Fa/FeHIF drug solubilities to values measured in a novel in vitro simulated nine media system for either the fasted (Fa9SIF) or fed (Fe9SIF) state. The manuscript contains 129 literature sampled human intestinal fluid equilibrium solubility values and 387 simulated intestinal fluid equilibrium solubility values. Statistical comparison does not detect a difference (Fa/Fe9SIF vs Fa/FeHIF), a novel solubility correlation window enclosed 95% of an additional literature Fa/FeHIF data set and solubility behaviour is consistent with previous physicochemical studies. The Fa/Fe9SIF system therefore represents a novel in vitro methodology for bioequivalent intestinal solubility determination. Combined with intestinal permeability this provides an improved, population based, biopharmaceutical assessment that guides formulation development and indicates the presence of food based solubility effects. This transforms predictive ability during drug discovery and development and may represent a methodology applicable to other multicomponent fluids where no single component is responsible for performance.

Neurolymphomatosis as primary presentation of extra-nodal NK/T-cell lymphoma, nasal type.

Neurolymphomatosis (NL) describes an infiltration of cranial and peripheral nerves by lymphoma cells, most frequently in non-Hodgkin B-cell lymphoma. This clinical entity is rare and poses a challenging diagnosis. We describe a case of a 64-year-old female patient with NL associated with extra-nodal NK/T-cell lymphoma (ENKTL), nasal type, presenting as a painful progressive mononeuropathy multiplex with an oral cavity lesion. ENKTL is usually associated with Epstein-Barr virus (EBV) infection and rarely affects the central and peripheral nervous system. Lumbar puncture, magnetic resonance imaging (MRI), nerve biopsy, and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) help to establish the diagnosis. Thereby, NL should be considered in the differential diagnosis of painful progressive multiple neuropathies, even in patients without previous history of cancer.

Application of the iPLUS non-coding sequence in improving biopharmaceuticals production.

The biotechnological landscape has witnessed significant growth in biological therapeutics particularly in the field of recombinant protein production. Here we investigate the function of 3'UTR cis-regulatory elements in increasing mRNA and protein levels in different biological therapeutics and model systems, spanning from monoclonal antibodies to mRNA vaccines. We explore the regulatory function of iPLUS - a universal sequence capable of consistently augmenting recombinant protein levels. By incorporating iPLUS in a vector to express a monoclonal antibody used in immunotherapy, in a mammalian cell line used by the industry (ExpiCHO), trastuzumab production increases by 2-fold. As yeast Pichia pastoris is widely used in the manufacture of industrial enzymes and pharmaceuticals, we then used iPLUS in tandem (3x) and iPLUSv2 (a variant of iPLUS) to provide proof-of-concept data that it increases the production of a reporter protein more than 100-fold. As iPLUS functions by also increasing mRNA levels, we hypothesize that these sequences could be used as an asset in the mRNA vaccine industry. In fact, by including iPLUSv2 downstream of Spike we were able to double its production. Moreover, the same effect was observed when we introduced iPLUSv2 downstream of MAGEC2, a tumor-specific antigen tested for cancer mRNA vaccines. Taken together, our study provides data (TLR4) showing that iPLUS may be used as a valuable asset in a variety of systems used by the biotech and biopharmaceutical industry. Our results underscore the critical role of non-coding sequences in controlling gene expression, offering a promising avenue to accelerate, enhance, and cost-effectively optimize biopharmaceutical production processes.

Sex differences in systemic inflammation and immune function in diet-induced obesity rodent models: A systematic review.

Understanding sex differences in immunological responses in the context of obesity is important to improve health outcomes. This systematic review aimed to investigate sex differences in systemic inflammation, immune cell phenotype, and function in diet-induced obesity (DIO) animal models. A systematic search in Medline, Embase, and CINAHL from inception to April 2023 was conducted, using a combination of the following concepts: sex, obesity, cytokines, and immune cell phenotypes/function. Forty-one publications reporting on systemic inflammation (61%), cell phenotype (44%), and/or function (7%) were included. Females had lower systemic inflammation compared with males in response to DIO intervention and a higher proportion of macrophage (M)2-like cells compared with males that had a higher proportion of M1-like in adipose tissue. Although there were no clear sex differences in immune function, high-fat DIO intervention remains an important factor in the development of immune dysfunction in both males and females, including disturbances in cytokine production, proliferation, and migration of immune cells. Yet, the mechanistic links between diet and obesity on such immune dysfunction remain unclear. Future studies should investigate the role of diet and obesity in the functionality of immune cells and employ adequate methods for a high-quality investigation of sex differences in this context.

Structured solubility behaviour in fed simulated intestinal fluids.

Intestinal drug solubility is a key parameter controlling absorption after the administration of a solid oral dosage form. The ability to measure fed state solubility in vitro is limited and multiple simulated intestinal fluid recipes have been developed but with no consensus which is optimal. This study has utilised nine bioequivalent simulated fed intestinal media recipes that cover over 90% of the compositional variability of sampled fed human intestinal fluid. The solubility of 24 drugs (Acidic; furosemide, ibuprofen, indomethacin, mefenamic acid, naproxen, phenytoin, piroxicam, valsartan, zafirlukast: Basic; aprepitant, atazanavir, bromocriptine, carvedilol, dipyridamole, posaconazole, tadalafil: Neutral; acyclovir, carbamazepine, felodipine, fenofibrate, griseofulvin, itraconazole, paracetamol, probucol) has been assessed to determine if structured solubility behaviour is present. The measured solubility behaviour can be split into four categories and is consistent with drug physicochemical properties and previous solubility studies. For acidic drugs (category 1) solubility is controlled by media pH and the lowest and highest pH media identify the lowest and highest solubility in 90% of cases. For weakly acidic, basic and neutral drugs (category 2) solubility is controlled by media pH and total amphiphile concentration (TAC), a consistent solubility pattern is evident with variation related to individual drug media component interactions. The lowest and highest pH × TAC media identify the lowest and highest solubility in 70% and 90% of cases respectively. Four drugs, which are non-ionised in the media systems (category 3), have been identified with a very narrow solubility range, indicating minimal impact of the simulated media on solubility. Three drugs exhibit solubility behaviour that is not consistent with the remainder (category 4). The results indicate that the use of two bioequivalent fed intestinal media from the original nine will identify in vitro the maximum and minimum solubility values for the majority of drugs and due to the media derivation this is probably applicable in vivo. When combined with a previous fasted study, this introduces interesting possibilities to measure a solubility range in vitro that can provide Quality by Design based decisions to rationalise drug and formulation development. Overall this indicates that the multi-dimensional media system is worthy of further investigation as in vitro tool to assess fed intestinal solubility.

Corrigendum: The nutrition and immunity (nutrIMM) study: protocol for a non-randomized, four-arm parallel-group, controlled feeding trial investigating immune function in obesity and type 2 diabetes.

[This corrects the article DOI: 10.3389/fnut.2023.1243359.].

The nutrition and immunity (nutrIMM) study: protocol for a non-randomized, four-arm parallel-group, controlled feeding trial investigating immune function in obesity and type 2 diabetes.

Introduction: Individuals with obesity and/or type 2 diabetes are at higher risk of infection and have worse prognoses compared to healthy individuals. Several factors may influence immune responses in this population, including high adiposity, hyperglycemia, and unhealthy dietary habits. However, there is insufficient data on the independent or clustered contribution of these factors to obesity-related immune dysfunction, especially accounting for dietary intake. This study aims to establish the independent contribution of obesity and hyperglycemia to immune dysfunction independent of diet in adults with and without obesity with or without type 2 diabetes. Methods: The Nutrition and Immunity (nutrIMM) study is a single-centre, non-randomized, four-arm, parallel-group, controlled feeding trial. It will enroll adults without obesity (Lean-NG) and with obesity and three metabolic phenotypes of normoglycemia, glucose intolerance, and type 2 diabetes. Participants will be assigned to one of four groups and will consume a standard North American-type diet for 4 weeks. The primary outcomes are plasma concentration of C-reactive protein and concentration of ex-vivo interleukin-2 secreted upon stimulation of T cells with phytohemagglutinin. Discussion: This will be the first controlled feeding study examining the contribution of obesity, hyperglycemia, and diet on systemic inflammation, immune cell phenotype, and function in adults of both sexes. Results of this clinical trial can ultimately be used to develop personalized dietary strategies to optimize immune function in individuals with obesity with different immune and metabolic profiles. Clinical trial registration: ClinicalTrials.gov, identifier NCT04291391.

Association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and cardiovascular risk factors: A two-year follow-up study in kidney transplant recipients.

BACKGROUND & AIMS: Recent evidence suggests that moderate coffee intake is associated with multiple health benefits, including lower risk of obesity, sarcopenia and cardiovascular disease (CVD) in the general population. However, to date, no study has evaluated these associations in kidney transplant recipients (KTR). The aim of the present study was to evaluate the association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and CVD risk factors in KTR. METHODS: This prospective 2 years-follow-up study included 170 KTR (59% men) aged 49.5 (42.0-57.0) years. At baseline participants were submitted to the following evaluations: clinical, laboratorial, dietary intake (including coffee), muscle strength, anthropometric and body composition by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). After two years 163 KTR were re-evaluated by anthropometry, BIA and muscle strength. Sarcopenia was defined according to EWGSOP2. Risk factors for CVD were hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and hyperhomcysteinemia. Participants were stratified according to coffee intake: 0 or 1 time/day (Gr0-1) and 2 or 3 times/day (Gr2-3). RESULTS: The median coffee consumption was 200 (150-250)mL/day and 112 (71-155)mL/1000 kcal/day. At baseline, Gr2-3 vs. Gr0-1 exhibited significantly higher values of waist circumference, waist-to-height ratio (WHtR) and presented a higher odds ratio for central obesity according to WHtR (2.68; 95%CI:1.19-6.02; p = 0.02) after adjustment for confounders. Coffee consumption (mL/1000 kcal/day) showed, even after adjustment for confounders, (1) a positive association with all parameters of body adiposity (anthropometry, BIA and DXA) and (2) a negative association with muscle quality index. After two years, coffee intake (mL/1000 kcal/day) at baseline presented a positive correlation with changes in fat mass (kg) by BIA (r = 0.22, p = 0.01) after adjustment for confounders. CONCLUSION: This study suggests that in KTR, higher coffee consumption is associated with increased adiposity, specially, central adiposity and lower muscle quality, but is not related with the other evaluated parameters.

Randomized controlled trials reporting the effects of probiotics in individuals with overweight and obesity: A critical review of the interventions and body adiposity parameters.

Obesity is a complex chronic metabolic disease that impairs health and reduces lifespan. Therefore, effective strategies for the prevention and treatment of obesity are necessary. Although several studies have demonstrated that gut dysbiosis is associated with obesity it, remains controversial whether the altered gut microbiota is a risk factor for or a consequence of obesity. Recent randomized clinical trials (RCTs) evaluating if gut microbiota modulation with probiotics favors weight loss present conflicting results, which can be attributed to the heterogeneity in the study designs. The aim of this paper is to make a comprehensive review describing the heterogeneity of interventions and body adiposity assessment methods of RCTs that evaluated the effects of probiotics on body weight and body adiposity in individuals with overweight and obesity. Thirty-three RCTs were identified through a search strategy. As main results we observed that ∼30% of the RCTs reported a significant decrease in body weight and body mass index (BMI) and ∼50% found a significant reduction in waist circumference and total fat mass. The beneficial effects of probiotics were more consistent in trials with ≥12 weeks, probiotics dose ≥1010 CFU/day, in capsules, sachets or powder, and without concomitant energy restriction. The evidence of probiotics effects on body adiposity may improve and be more consistent in future RCTs which include methodological characteristics such as longer duration, higher dose, non-dairy vehicle, non-concurrent energy restriction and use of more accurate measures of body fat deposits (e.g., body fat mass and waist circumference) instead of body weight and BMI.

Fed intestinal solubility limits and distributions applied to the Developability classification system.

For solid oral dosage forms drug solubility in intestinal fluid is an important parameter influencing product performance and bioavailability. Solubility along with permeability are the two parameters applied in the Biopharmaceutics and Developability Classification Systems (DCS) to assess a drug's potential for oral administration. Intestinal solubility varies with the intestinal contents and the differences between the fasted and fed states are recognised to influence solubility and bioavailability. In this study a novel fed state simulated media system comprising of nine media has been utilised to measure the solubility of seven drugs (ibuprofen, mefenamic acid, furosemide, dipyridamole, griseofulvin, paracetamol and acyclovir) previously studied in the fasted state DCS. The results demonstrate that the fed nine media system provides a range of solubility values for each drug and solubility behaviour is consistent with published design of experiment studies conducted in either the fed or fasted state. Three drugs (griseofulvin, paracetamol and acyclovir) exhibit very narrow solubility distributions, a result that matches published behaviour in the fasted state, indicating that this property is not influenced by the concentration of simulated media components. The nine solubility values for each drug can be utilised to calculate a dose/solubility volume ratio to visualise the drug's position on the DCS grid. Due to the derivation of the nine media compositions the range and catergorisation could be considered as bioequivalent and can be combined with the data from the original fed intestinal fluid analysis to provide a population based solubility distribution. This provides further information on the drugs solubility behaviour and could be applied to quality by design formulation approaches. Comparison of the fed results in this study with similar published fasted results highlight that some differences detected match in vivo behaviour in food effect studies. This indicates that a combination of the fed and fasted systems may be a useful in vitro biopharmaceutical performance tool. However, it should be noted that the fed media recipes in this study are based on a liquid meal (Ensure Plus) and this may not be representative of alternative fed states achieved through ingestion of a solid meal. Nevertheless, this novel approach provides greater in vitro detail with respect to possible in vivo biopharmaceutical performance, an improved ability to apply risk-based approaches and the potential to investigate solubility based food effects. The system is therefore worthy of further investigation but studies will be required to expand the number of drugs measured and link the in vitro measurements to in vivo results.

Acute kidney injury patterns in acute heart failure: The prognostic value of worsening renal function and its timing.

INTRODUCTION: Acute decompensated heart failure (ADHF) admissions are frequently complicated by different patterns of serum creatinine (SCr) elevation. We aimed to assess the prognostic impact of worsening renal function (WRF) based on the timing of its occurrence. METHODS: This was a retrospective cohort of patients admitted for ADHF. Standard WRF was defined as an increase in SCr of ≥0.3 mg/dl during hospitalization. WRF timing was classified as early (within 48 hours of admission) or late (>48 hours). Acute kidney injury (AKI) at admission was defined as a rise in SCr of ≥0.3 mg/dl from outpatient baseline measurement to first measurement at admission. The primary endpoint was a composite of all-cause mortality or hospitalization for cardiovascular events at one-year follow-up. RESULTS: Overall, 249 patients were included (mean age 77±11 years, 62% with preserved left ventricular ejection fraction). Early WRF occurred in 49 patients (19.7%) and was associated with a higher risk of the primary outcome (HR 2.49; 95% CI 1.66-3.73), whereas late WRF was not (p=0.411). After stratification for the presence of early WRF and/or AKI at admission, only patients with early WRF but no AKI at admission and patients with both AKI at admission and early WRF showed a higher risk of the primary outcome after multivariate Cox regression. CONCLUSION: Early WRF was associated with a higher risk of the primary outcome. The timing of WRF seems to be an important factor to take into account when considering the prognostic impact of creatinine variations during hospitalization for ADHF.

Soaking to Reduce Potassium and Phosphorus Content of Foods.

OBJECTIVES: To achieve and maintain normal serum potassium and phosphorus levels reducing potassium and phosphorus intake is frequently recommended for adults living with chronic kidney disease. Exploring food preparation methods to reduce potassium and phosphorus content appears warranted. The study aim is to determine the impact of soaking foods in hot water on potassium and phosphorus content in a variety of plant- and animal-based foods. METHODS: Twenty foods were selected that are common staples in Brazilian diet patterns. Food was soaked for 5-10 minutes in deionized water that had been brought to a boil and then removed from heat using a 5-part water to 1-part sample ratio. The potassium content was determined by flame photometry. The phosphorus content was determined by visible ultraviolet spectrophotometry. RESULTS: Soaking foods resulted in a reduction in potassium and phosphorus. Potassium reduction in beef, green leafy vegetables, and grains was 40-49%; in chicken, fish, and nonleafy vegetables 30-39%; and tubers 10-20%. Phosphorus reduction in grains and beans was 30-39%; in nonleafy vegetables 20-29%; and beef, chicken, and fish 10-20%. CONCLUSIONS: Soaking foods in hot water for 5-10 minutes reduces potassium and phosphorus content. Using this technique to prepare foods may be a more acceptable alternative to longer demineralization periods making it easier for adults living with chronic kidney disease to follow diet recommendations.

Effects of weight loss through lifestyle changes on heart rate variability in overweight and obese patients: A systematic review.

BACKGROUND & AIMS: The effects of calorie restriction and physical activity on autonomic regulation and cardiac vagal control in overweight and obese individuals remain inconsistent. Thus, this systematic review aimed to evaluate the weight loss effects through lifestyle changes on heart rate variability (HRV) markers in overweight and obese subjects. METHODS: A systematic search for studies published up to November 2021 was conducted in MEDLINE, Embase, EBSCO host and VHL REGIONAL/LILACS. The main outcomes were changes in HRV indices from pre- and post-nutritional intervention and exercise in overweight and obese individuals. This review was registered in PROSPERO: CRD42021274467. RESULTS: The literature search retrieved 959 articles, of which 12 were included in this review. The intervention in nine studies was diet only, in two studies was diet and exercise, and in one study diet was compared to diet and exercise. The weight loss was greater than 10% in four studies and between 5 and 10% in three studies. Most of the studies revealed that weight loss through lifestyle changes seems to promote beneficial effects on HRV, restoring sympathovagal balance by increasing parasympathetic activity and reducing sympathetic activation. CONCLUSION: This systematic review exhibited the beneficial effects of weight loss through lifestyle changes on cardiac autonomic control in overweight and obese individuals. Future investigations need standardization of HRV indices for better interpretation of autonomic function in different clinical situations.

Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment.

PURPOSE OF REVIEW: This review summarizes literature from the last 18 months reporting on sarcopenia (or its components) in chronic kidney disease (CKD). RECENT FINDINGS: The prevalence of sarcopenia in CKD is reported to be 5-62.5%, with higher rates observed later in the disease. Sarcopenic obesity rates are reported to be 2-23%. Sarcopenia in CKD is associated with increased risk of mortality, cardiovascular disease and vascular calcification. Risk factors include kidney disease itself and the impacts of CKD on lifestyle (reduced physical activity, diet changes). In earlier stages of CKD, if the risks from sarcopenia outweigh the risk of reaching end-stage renal disease, ensuring adequate energy intake combined with modest protein liberalization and physical activity may be indicated. Protein intakes above 1.3 g/kg of body weight per day should be avoided. For dialysis patients, interventions that provide a combination of carbohydrate, protein and fat appear more effective than those that provide protein alone, though it may take as long as 48 weeks for detectable changes in muscle mass. SUMMARY: Sarcopenia is prevalent in CKD as kidney disease significantly impacts muscle mass and function. Nutrition interventions can improve components of sarcopenia, with an emphasis on adequate energy and protein.

Comparison of Patients Monoinfected with Hepatitis C Virus and Coinfected with Hepatitis B/C in the Amazon Region of Brazil.

Hepatitis B and C are the most common causes of liver disease worldwide. The two infections share many similarities such as a global distribution, the same routes of transmission, hepatotropism, and the ability to cause chronic infection. The consequences of HBV/HCV coinfection are still being studied. The aim of this study is to describe and compare the epidemiological and laboratory profile and the degree of hepatic fibrosis between HCV-monoinfected and HBV/HCV-coinfected patients in the Brazilian Amazon region. ELISA tests were used for the investigation of HBV and HCV serological markers, and molecular tests were used for the detection and genotyping of these viruses. Additionally, transaminases were measured, and a FibroScan was performed for the analysis of liver function. A total of 328 patients with HCV participated in the study. The serological prevalence of HCV/HBV coinfection was 10.77%. A comparison of risk factors between the monoinfected and coinfected groups showed that illicit drug use, sharing sharp instruments, and tattooing/piercing are significantly associated with coinfection. The monoinfected patients had a higher HCV load than the coinfected patients. A viral interaction was observed in this study in which the presence of a coinfection with HBV appears to influence HCV replication. Further studies are necessary to better understand this interaction.

Osteosarcopenia in patients with non-dialysis dependent chronic kidney disease.

INTRODUCTION: Chronic kidney disease (CKD) is associated with a reduction in bone mineral density (BMD), but less is understood regarding the relation between BMD and muscle mass, especially in non-dialysis dependent-CKD (NDD-CKD). The aim of this study was to explore the prevalence and association of low BMD (osteopenia and osteoporosis) with markers of muscle mass and function in patients with NDD-CKD. METHODOLOGY: This cross-sectional observational study included patients with NDD-CKD. Routine biochemical parameters including those related to mineral and bone metabolism were evaluated. Body composition was assessed by dual energy x-ray absorptiometry (DXA) for BMD (g/cm2), total and trunk body fat (%), total lean soft tissue (LST; kg), and appendicular skeletal muscle mass (ASM; kg) as the sum of the LST from the limbs. The latter two variables were used as markers of muscle mass, together with its height indexed values: ASM/height2 as ASM index (ASMI; kg/m2), and LST/height2 as LST index (LSTI, kg/m2). Muscle quality index (MQI) was calculated as handgrip strength (HGS)/mean ASMarms (kg/kg). Osteosarcopenia was defined according to referenced cut-points for patients presenting with low ASMI, HGS and BMD. RESULTS: Patients (n = 257, 57.6% males) had a mean age = 64.8 ± 12.9 years, estimated glomerular filtration rate (eGFR) = 30.1 ± 12.9 ml/min and body mass index (BMI) = 26.8 ± 4.8 kg/m2. Patients with low BMD (39.4%) presented with lower BMI, LST, LSTI, ASM and ASMI for both sexes. BMD was positively and significantly correlated with LST, LSTI, ASM, ASMI and HGS. Low ASM was associated with low BMD (odds-ratio-OR; 95% confidence interval-CI: males OR = 4.54, 2.02-10.21; females OR = 4.45, 1.66-11.93). Linear multiple regression analysis (adjusted for sex and eGFR) showed significant associations between T-score with HGS (R2 = 0.288, R2 adjusted = 0.272, standardized coefficient ß = 0.536, p < 0.0001) and also with MQI (R2 = 0.095, R2 adjusted = 0.075, standardized coefficient ß = 0.309, p = 0.024). Osteosarcopenia was present in about 7% of participants and similarly distributed between sexes. CONCLUSION: Low BMD was prevalent, and associated with low markers of muscle mass and quality, in NDD-CKD patients of both sexes. In view of the known significance of these conditions, targeted interventions are needed to optimize body composition and functional status of these patients.