Hospital da Criança de Brasília José Alencar, Brasília, Federal District, Brazil.
Faculty of Health Sciences, University of Brasília, Brasília, Federal District, 70910-900, Brazil.
Pediatr Nephrol. 2024 Feb;39(2):539-545. doi: 10.1007/s00467-023-06111-9. Epub 2023 Aug 11.
Pediatric patients with chronic kidney disease (CKD) frequently present an inadequate nutritional profile and musculoskeletal impairments. We investigated sarcopenia and its related traits in children and adolescents with CKD.
A cross-sectional study that enrolled pediatric patients with CKD (≥ 4 and < 18 years old). Physical function was assessed by handgrip strength and the 60-s sit-to-stand (STS-60) tests. Body composition measurement was performed by bioelectrical impedance analysis and anthropometry through mid-upper arm circumference (MUAC). Normative reference values from healthy pediatrics were used for identifying poor physical function and low MUAC. Probable sarcopenia was considered as low handgrip strength, whereas sarcopenia was defined by adding low MUAC.
Twenty-two pediatric patients with CKD (11 ± 4 years and 59% boys) were evaluated; eight on peritoneal dialysis (36%), six on hemodialysis (27%), and eight non-dialysis (36%). Regarding sarcopenia traits, we observed low physical function by handgrip strength and STS-60 in 59% and 100% of the patients, respectively, while low MUAC in 77%. Probable sarcopenia was found in 9% and sarcopenia in 50%, but prevalence did not differ among stages. Handgrip strength was strongly associated with MUAC (r = 0.90; p < 0.001); on the other hand, the STS-60 was not significantly associated with any of the body composition variables.
Among pediatric patients with CKD, the prevalence of sarcopenia and its related traits was high. Nephrology professionals should consider the assessment of sarcopenia in this population, while more evidence is needed to determine its prognostic value. A higher resolution version of the Graphical abstract is available as Supplementary information.
患有慢性肾脏病（CKD）的儿科患者常表现出营养状况不佳和肌肉骨骼损伤。我们研究了 CKD 患儿的肌肉减少症及其相关特征。
这是一项横断面研究，纳入了年龄≥4 岁且<18 岁的 CKD 儿科患者。通过握力和 60 秒坐站测试（STS-60）评估身体机能。通过生物电阻抗分析和中上臂围（MUAC）进行人体成分测量。使用健康儿科人群的参考值来确定身体机能差和 MUAC 低。低握力被认为是可能的肌肉减少症，而添加 MUAC 低则被定义为肌肉减少症。
共评估了 22 名 CKD 儿科患者（11±4 岁，59%为男性）；其中 8 名患者接受腹膜透析（36%），6 名患者接受血液透析（27%），8 名患者未接受透析（36%）。在肌肉减少症特征方面，我们观察到手握力和 STS-60 测试的患者中分别有 59%和 100%的患者存在低身体机能，77%的患者 MUAC 低。9%的患者存在可能的肌肉减少症，50%的患者存在肌肉减少症，但各分期之间的患病率无差异。握力与 MUAC 呈强相关（r=0.90；p<0.001）；另一方面，STS-60 与任何身体成分变量均无显著相关性。
在 CKD 儿科患者中，肌肉减少症及其相关特征的患病率较高。肾病科医生应考虑在该人群中评估肌肉减少症，同时需要更多证据来确定其预后价值。一个更高分辨率的图表摘要版本可以在补充信息中查看。
