Prognostic value of sarcopenia in patients with CKD


DOI: https://dx.doi.org/10.18565/nephrology.2019.1.48-55

A.V. Sokolova, D.O. Dragunov, G.P. Arutyunov, V.M. Mitrokhin

Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation; Moscow, Russia
Objective. Evaluation of the prognostic role of sarcopenia in patients with CKD.
Materials and methods. The study included 79 patients with an proven diagnosis of CKD and AH or CAD. GFR was calculated using the CKD-EPI formula. The diagnosis of CKD was verified in accordance with the KDIGO recommendations; the diagnosis of sarcopenia – in accordance with the EWGSOP recommendations. Progression of CKD was determined as an increase in the CKD stage during the year. The end points were the presence of any cardiovascular events, including coronary intervention, and/or the death of the patient. For statistical analysis of the data obtained, the R language RStudio software (packages psych, epiR, ggplot2, dplyr) was used.
Results. The mean age of patients was 74.97±8.27 years, CHF was detected in 34.2% of patients, and progression of CKD was detected in 40.5% of patients, of which 20.3% of patients had sarcopenia. A direct, reverse, significant relationship was found between the progression of CKD and the presence of sarcopenia in patients (Р=0.043). 23 endpoints were registered. In patients with sarcopenia, there was a tendency to increase the IL-18 and IL-6 levels, and a decrease in the anti-inflammatory cytokine IL-10 level. However, no differences were found in the IL-18 and IL-6 levels in patients with and without sarcopenia. The data obtained demonstrates that with an average log IL-18 level equal to 4.7, an increase by 1 leads to an increase in log IL-6 by 0.23. The logit regression model and OR showed that the IL-18 level most influences the risk of the end points being studied. The risk of end-point development increases by 5.76 times when patients with CKD have high IL-18 levels.
Conclusion. Thus, it can be concluded that anti-inflammatory system of interleukins has a greater prognostic value for patients with CKD and sarcopenia.

About the Autors


Arutyunov G.P. – Doctor of Medical Sciences, Professor, Corresponding Member of RAS, Head of the Department of Propaedeutics of Internal Diseases of the Faculty of Pediatrics, Pirogov RNRMU of the Ministry of Health of the Russian Federation; Moscow, Russia.
Dragunov D.O. – PhD in Medical Sciences, Associate Professor at the Department of Propedeutics of Internal Diseases, Faculty of Pediatrics, N.I. Pirogov RNRMU of the Ministry
of Health of the Russian Federation; Moscow, Russia.Email: tamops2211@gmail.com
Sokolova A.V. – PhD in Medical Sciences, Teaching Assistant at the Department of Propedeutics of Internal Diseases, Faculty of Pediatrics, N.I.Pirogov RNRMU of the Ministry
of Health of the Russian Federation; Moscow, Russia.
Mitrokhin V.M. – PhD in Medical Sciences, Associate Professor at the Department of Propedeutics of Internal Diseases, Faculty of Pediatrics, N.I.Pirogov RNRMU of the Ministry
of Health of the Russian Federation; Moscow, Russia.


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