Dados do Trabalho

Título

PREVALENCE OF SARCOPENIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A GLOBAL SYSTEMATIC REVIEW AND META-ANALYSIS

Introdução

Sarcopenia is a risk factor for adverse clinical outcomes in chronic kidney disease (CKD) patients, including mortality. Diagnosis depends on the consensus definition and cutoff adopted and prevalence is generally heterogeneous. We conducted a systematic review and meta-analysis to investigate the global prevalence of sarcopenia across the wide spectrum of CKD.

Material e Método

A systematic search was conducted using MEDLINE, EMBASE, Web of Science, CINAHL and LILACS databases for observational studies reporting the prevalence of sarcopenia. The consensus guidelines European Working Group on Sarcopenia in Older People (EWGSOP), Asian Working Group for Sarcopenia, Foundation for the National Institutes of Health Sarcopenia Project, and International Working Group on Sarcopenia were considered. Subgroup analyses by CKD stages, consensus, gender, and sarcopenia traits were performed. Pooled prevalence was obtained from random-effect models using the metaprop command in Stata.

Resultados

A total of 99 studies with 29,495 participants were included in meta-analyses. According to the different consensus, the prevalence of sarcopenia varied between 13% and 27%. Global prevalence of sarcopenia was 24.8% [95% confidence interval (IC): 20.5−29.4, I2 = 98.6%). The highest prevalence was observed using the EWGSOP criteria [30.1% (95% CI: 24.6−35.8)] and in the dialysis population 31.3% (95% CI: 20.2−43.7). Low muscle strength was found in 43.8% (95% CI: 33.7−54.1), whereas low muscle mass in 27.6% (95% CI: 21.8−33.9). The prevalence of severe sarcopenia was 19.6% (20.5−29.4, I2 = 98.7%) while sarcopenic obesity was found in 10.6% (95% CI: 7.4−14.2).

Discussão e Conclusões

We found a high global prevalence of sarcopenia in the wide spectrum of CKD. Low muscle strength, the primary sarcopenia trait, had an almost twofold higher prevalence than low muscle mass. Sarcopenia prevalence varied according to the consensus definition. Identification and management of sarcopenia and its traits should be implemented in clinical settings, which could contribute to improvements in clinical adverse outcomes.

Palavras Chave

chronic kidney disease, dialysis, cachexia, skeletal muscle mass, muscle strength, physical function