J Cachexia Sarcopenia Muscle:肌肉减少症大大增加CKD患者进展成终末肾病和死亡的风险!

2021-05-06 MedSci原创 MedSci原创

肌肉减少症的存在增加了CKD患者死亡和终末期肾病的风险。明确肌肉减少症或有助于识别高危的CKD患者

肌肉减少症(Sarcopenia)是一种退行性的全身性骨骼肌疾病,是指因持续骨骼肌量流失、强度和功能下降而引起的综合症,在临床实践中常是一个被忽视的问题,特别是在慢性肾脏疾病(CKD)患者中。

本研究旨在调查肌肉减少症在CKD患者中的患病率、危险因素及其与CKD患者全因死亡率和进展为终末期肾病(ESRD)的关系

研究人员根据有无CKD(定义为估计肾小球滤过率<60nmL/min/1.73m2)和有无低握力、低肌肉质量和严重的肌肉减少将UK Biobank参与者进行了分组。

共纳入了428320名受试者,其中8767名CKD患者:46%为男性,平均62.8岁,估计肾小球滤过率中位数为54.5(四分位数范围49.0~57.7)mL/min/1.72m2

CKD患者发生肌肉减少症的相关风险因素

约9.7%的CKD患者可能存在肌肉减少,而非CKD患者仅有5.0%(P<0.001)。肌肉减少症与年龄增大、炎症、肾功能较差以及血清白蛋白、总睾酮和血红蛋白降低有关。

肌肉减少的最大危险因素是有三个或以上的合并症(优势比:2.3;95%CI:1.6-3.29;P<0.001)和缺乏体力活动:每周活动量最高四分位数的受试者比最低四分位数的受试者患肌肉减少症的可能性减少43%(优势比:0.57;0.42-0.76;P<0.001)。

合并肌肉减少症的CKD患者的死亡和终末肾病风险

与没有患肌肉减少症和CKD的个体相比,肌肉减少症合并CKD的患者的死亡率高出33%(7%-66%;P=0.011)。合并肌肉减少症的CKD患者的10年生存率为0.85(0.82~0.88),而没有肌肉减少症的CKD患者的10年生存率为0.89(0.88~0.30),绝对差为4%。

合并肌肉减少症的CKD患者发生终末期肾病的可能性是对照组的两倍(危险比:1.98;1.45-2.7;P<0.001)。

综上所述,肌肉减少症的存在增加了CKD患者死亡和终末期肾病的风险。明确肌肉减少症或有助于识别高危的CKD患者。此外,应该鼓励CKD患者多进行体力活动等干预措施,以减轻肌肉减少症的发生。

原始出处:

Wilkinson Thomas J,Miksza Joanne,Yates Thomas et al. Association of sarcopenia with mortality and end-stage renal disease in those with chronic kidney disease: a UK Biobank study. J Cachexia Sarcopenia Muscle, 2021, https://doi.org/10.1002/jcsm.12705

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    2022-02-08 feather89
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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a965506641, createdName=Blueblue7, createdTime=Mon May 24 00:21:31 CST 2021, time=2021-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963861, encodeId=3e4696386148, content=学习了!获益, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73835475130, createdName=我是谁是我, createdTime=Sun May 09 06:21:18 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393398, encodeId=d0ce1393398e5, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, 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encodeId=4e399631865d, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu May 06 19:52:03 CST 2021, time=2021-05-06, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1768855, encodeId=b9ab1e688554d, content=<a href='/topic/show?id=51cd4e9650' target=_blank style='color:#2F92EE;'>#CKD患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4796, encryptionId=51cd4e9650, topicName=CKD患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9fa237912269, createdName=12498f17m78暂无昵称, createdTime=Wed Jul 14 13:48:33 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647104, encodeId=bf35164e104c3, content=<a href='/topic/show?id=fd6d809e535' target=_blank style='color:#2F92EE;'>#肌肉减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80975, encryptionId=fd6d809e535, topicName=肌肉减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Nov 16 05:48:33 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728935, encodeId=89ab1e28935a7, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Feb 08 12:48:33 CST 2022, time=2022-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079702, encodeId=cc4020e97021d, content=<a href='/topic/show?id=8b651589489' target=_blank style='color:#2F92EE;'>#sarcopenia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a965506641, createdName=Blueblue7, createdTime=Mon May 24 00:21:31 CST 2021, time=2021-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963861, encodeId=3e4696386148, content=学习了!获益, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73835475130, createdName=我是谁是我, createdTime=Sun May 09 06:21:18 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393398, encodeId=d0ce1393398e5, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, 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encodeId=4e399631865d, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu May 06 19:52:03 CST 2021, time=2021-05-06, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1768855, encodeId=b9ab1e688554d, content=<a href='/topic/show?id=51cd4e9650' target=_blank style='color:#2F92EE;'>#CKD患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4796, encryptionId=51cd4e9650, topicName=CKD患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9fa237912269, createdName=12498f17m78暂无昵称, createdTime=Wed Jul 14 13:48:33 CST 2021, time=2021-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647104, encodeId=bf35164e104c3, content=<a href='/topic/show?id=fd6d809e535' target=_blank style='color:#2F92EE;'>#肌肉减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80975, encryptionId=fd6d809e535, topicName=肌肉减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Tue Nov 16 05:48:33 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728935, encodeId=89ab1e28935a7, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Feb 08 12:48:33 CST 2022, time=2022-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079702, encodeId=cc4020e97021d, content=<a href='/topic/show?id=8b651589489' target=_blank style='color:#2F92EE;'>#sarcopenia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a965506641, createdName=Blueblue7, createdTime=Mon May 24 00:21:31 CST 2021, time=2021-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963861, encodeId=3e4696386148, content=学习了!获益, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73835475130, createdName=我是谁是我, createdTime=Sun May 09 06:21:18 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393398, encodeId=d0ce1393398e5, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, encryptionId=e2f4809e7e9, topicName=肌肉减少症)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIOca9icPByKxo3ZRUrvuibf7tWt7EScQ1NEiaKy4NCUctSU2jDjOayLicDIaicwUxaQhJ1SZKdEevgjRg/132, createdBy=4f272500131, createdName=若水123, createdTime=Sat May 08 08:48:33 CST 2021, time=2021-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541650, encodeId=48c11541650ef, content=<a href='/topic/show?id=0d9239585e' target=_blank style='color:#2F92EE;'>#CAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3958, encryptionId=0d9239585e, topicName=CAC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=044f13304956, createdName=ms9651749636653578, createdTime=Sat May 08 08:48:33 CST 2021, time=2021-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963186, encodeId=4e399631865d, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu May 06 19:52:03 CST 2021, time=2021-05-06, status=1, ipAttribution=)]
    2021-05-24 Blueblue7

    学习

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a965506641, createdName=Blueblue7, createdTime=Mon May 24 00:21:31 CST 2021, time=2021-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=963861, encodeId=3e4696386148, content=学习了!获益, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73835475130, createdName=我是谁是我, createdTime=Sun May 09 06:21:18 CST 2021, time=2021-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393398, encodeId=d0ce1393398e5, content=<a href='/topic/show?id=e2f4809e7e9' target=_blank style='color:#2F92EE;'>#肌肉减少症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80977, 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encodeId=4e399631865d, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu May 06 19:52:03 CST 2021, time=2021-05-06, status=1, ipAttribution=)]
    2021-05-09 我是谁是我

    学习了!获益

    0

  8. 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  9. 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  10. 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    2021-05-06 jyzxjiangqin

    好文章!

    0

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