Karakousis Nikolaos D, Georgakopoulos Petros N
Independent Researcher, Vrilissia 15235, Greece.
Internal Medicine Department, Primary Healthcare, Amarousion 15125, Greece.
Muscles. 2023 Sep 22;2(4):317-326. doi: 10.3390/muscles2040024.
Loop diuretics (LDs) are used to treat various health conditions including heart failure (HF), liver cirrhosis, and chronic kidney disease (CKD). Sarcopenia is a skeletal muscle health issue related to the depletion and decrease of muscle mass and strength, leading to adverse outcomes including frailty syndrome, functional decline, falls, hospitalizations, augmented length of hospital stay, and increased morbidity and mortality.
This study investigated the probable association between LD use and sarcopenia via conducting a non-systematic review of the existing literature.
In subjects with non-dialysis-dependent chronic kidney disease (NDD-CKD), an augmented risk of sarcopenia is significantly associated with LD use. Interestingly, in patients with HF treated with LDs, thigh and arm circumferences were significantly small, which is indicative of skeletal muscle wasting. Additionally, in anorexic subjects who are more likely to be on diuretic medication, suffering also from cachexia, a higher prevalence of sarcopenia was demonstrated. In cirrhotic subjects, the treatment dosage of LDs was inversely correlated with the skeletal muscle area per year (ΔSMA). Nevertheless, in subjects with liver cirrhosis treated with LDs, who were divided into those with and those without muscle cramps, the presence of sarcopenia was similar.
Further investigation is imperative to validate potential interplay between LDs and sarcopenia.
袢利尿剂（LDs）用于治疗多种健康状况，包括心力衰竭（HF）、肝硬化和慢性肾脏病（CKD）。肌肉减少症是一种骨骼肌健康问题，与肌肉质量和力量的消耗及减少有关，会导致包括衰弱综合征、功能衰退、跌倒、住院、住院时间延长以及发病率和死亡率增加等不良后果。
本研究通过对现有文献进行非系统性综述，调查LDs使用与肌肉减少症之间可能存在的关联。
在非透析依赖型慢性肾脏病（NDD-CKD）患者中，使用LDs与肌肉减少症风险增加显著相关。有趣的是，在接受LDs治疗的HF患者中，大腿和上臂周长明显较小，这表明骨骼肌萎缩。此外，在更可能使用利尿药物且同时患有恶病质的厌食症患者中，肌肉减少症的患病率更高。在肝硬化患者中，LDs的治疗剂量与每年的骨骼肌面积（ΔSMA）呈负相关。然而，在接受LDs治疗的肝硬化患者中，无论有无肌肉痉挛，肌肉减少症的存在情况相似。
必须进行进一步研究以验证LDs与肌肉减少症之间潜在的相互作用。
