Akademik Veri Yönetim Sistemi
American Geriatrics Society (AGS) 2015 Annual Scientific Meeting, Maryland, Amerika Birleşik Devletleri, 15 - 17 Mayıs 2015, ss.203-204
Background: Estimation of glomerular filtration rate (GFR) is important in older adults and chronic kidney disease (CKD) is a risk factor for sarcopenia. However, presence of sarcopenia may result in erroneous estimation of GFR. We aimed to compare the association between commonly used GFR estimations and handgrip strength (HS) in this study.
Methods: We enrolled subjects ≥ 60 years old in this study. We excluded subjects with a history of cancer or those with a GFR < 30 ml/min according to any of GFR estimations. We measured subjects’ weights and heights. We analyzed blood urea nitrogen, creatinine, cystatin C (CC), and albumin levels. We used Cockcroft Gault (CG), short modification of diet in renal disease (MDRD) corrected for body surface area and CKD-EPI-CC formulas for GFR estimation. Subjects were grouped according to their GFR levels (decreased-GFR: <60 ml/min and preserved-GFR: ≥60 ml/min). We measured HS with a dynamometer. HS was compared in GFR groups. HS of 301 younger (18-39 years) healthy subjects was used to determine sarcopenic HS (more than 2 standard deviations below mean HS values).
Results: We enrolled 474 older adults (55.7% females) with a mean age 68±6.6. Frequency of decreased GFR was 12.6% and 11.5% according to CKD-EPI-CC and CG estimations, respectively. MDRD estimation resulted in a higher proportion of patients with decreased GFR (23.1%). HS of the patients with decreased GFR according to CG (24.7±9 vs. 27.7±9.8, p=0.015) and CKD-EPI-CC (24.9±9.3 vs. 27.9±9.9, p=0.013) estimations were lower compared with those with preserved GFR. On the contrary, patients with decreased GFR according to MDRD estimation had higher HS (31.8±10.3 vs. 24.9±8.6, p<0.001). The rate of sarcopenic HS was similar in decreased and preserved MDRD-GFR groups (66% vs. 66.3%) while it was higher in decreased GFR groups according to CG (80.3% vs. 63.5%, p=0.005) and CKD-EPI-CC (78.3% vs. 62.7%, p=0.006) estimations.
Conclusions: A GFR < 60 ml/min was a risk factor for sarcopenic HS according to CG and CKD-EPI-CC estimations. However, a decreased-GFR according to short MDRD estimation was associated with higher HS. These findings render a decreased GFR according to MDRD estimation an unreliable risk factor for sarcopenic muscle strength.