Sarcopenia em diálise peritoneal: prevalência, associações clínicas e nutricionais
Carregando...
Data
2019-02-22
Autores
Silva, Maryanne Zilli Canedo da
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
INTRODUÇÃO: Atualmente, várias sociedades internacionais reconhecem a presença da sarcopenia nas doenças catabólicas, como a doença renal crônica. Sarcopenia afeta qualidade de vida e atividades diárias dos indivíduos. O objetivo deste trabalho foi avaliar o diagnóstico, prevalência e associação de parâmetros clínicos e nutricionais com a sarcopenia em pacientes em diálise peritoneal (DP). MÉTODOS: Realizado busca ativa da sarcopenia em pacientes prevalentes em DP maiores de 18 anos. Avaliação da massa muscular pelo índice de massa apendicular (IMMA) e da função muscular pela força de preensão manual (FPM) foram realizadas. Diagnóstico de sarcopenia foi realizado de acordo com o European Working Group on Sarcopenia in Older People (EWGSOP) e sua gravidade foi avaliada por teste de velocidade de marcha (VM). Para análise estatística, foi utilizado teste Kolmogorov-Smirnov, seguido de qui quadrado ou exato de Fisher, Mann-Whitney ou Teste t de Student, de acordo com a distribuição dos dados. Posteriormente, foi realizada regressão logística multivariada. As variáveis com significância <0,1 na análise univariada foram incluídas no modelo de regressão. RESULTADOS: Foram incluídos cinquenta indivíduos em DP, média de idade de 55,74±16,22 anos, 52% eram mulheres. A prevalência de sarcopenia em DP foi de 10% (n=5), sendo 8% (n=4) considerados com sarcopenia severa. Comparando os grupos de pacientes de acordo com a presença de sarcopenia, foram encontradas diferenças significativas com relação ao peso (55,34±7,01kg vs 70,78±15,60kg, p=0,003), índice de massa corporal (IMC) (22,75±1,45kg/m² vs 26,35±4,61kg/m², p=0,002), FPM (14,00 (10,5-21,0)kg vs 23,00 (19,0-35,5)kg, p=0,024), IMMA (6,00 (5,8-6,5)kg/m² vs 7,24 (6,22-8,43)kg/m², p=0,017) e paratormônio - PTH (578,00 (419,5-763,00)pg/mL vs 246,00 (186,0-493,5)pg/mL, p=0,027). Não foram observadas associações com a presença de sarcopenia e as variáveis preditoras testadas. CONCLUSÃO: A prevalência de sarcopenia nos pacientes em DP foi de 10%. Foram encontradas diferenças entre os grupos com relação ao peso, IMC, FPM, IMMA e concentração sérica de PTH. Não foram observadas associações independentes entre sarcopenia e parâmetros clínicos e nutricionais.
INTRODUCTION: Currently, several international societies recognize the presence of sarcopenia in catabolic diseases, such as chronic kidney disease. Sarcopenia affects quality of life and daily activities of individuals. The aim of this study was to evaluate the diagnosis, prevalence and association of clinical and nutritional parameters with sarcopenia in patients on peritoneal dialysis (PD). METHODS: Screening for sarcopenia was performed in prevalent patients in PD older than 18 years. Muscle mass by appendicular skeletal muscle mass index (ASMMI) and muscle function by handgrip strength (HGS) were evaluated. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP) and its severity was assessed by gait speed (GS). For statistical analysis, Kolmogorov-Smirnov test was used, followed by Chi-square or Fisher's exact test, Mann-Whitney or Student´s t Test, according to data distribution. Later, binary logistic regression was performed. Variables with significance <0.1 in the univariate analysis were included in the binary logistic regression model. RESULTS: Fifty subjects on PD were included, mean age 55.74±16.22 years, 52% female. Sarcopenia prevalence was 10% (n=5), and 8% (n=4) were classified as severe sarcopenia. Comparing the groups of patients according to the presence of sarcopenia, significant differences were found regarding body weight (55.34±7.01kg vs 70.78±15.60kg, p=0.003), body mass index (BMI) (22.75±1.45kg/m² vs 26.35±4.61kg/m², p=0.002), HGS (14.00 (10.5-21.0)kg vs 23.00 (19.0-35.5)kg, p=0.024), ASMMI (6.00 (5.8-6.5)kg/m² vs 7.24 (6.22-8.43)kg/m², p=0.017) and parathyroid hormone (578.00 (419.5-763.00)pg/mL vs 246.00 (186.0-493.5)pg/mL, p=0.027). No associations were observed with the presence of sarcopenia and the predictive variables tested. CONCLUSIONS: Sarcopenia prevalence in patients on PD was 10%. Differences were found between groups in relation to body weight, BMI, HGS, ASMMI and serum PTH levels. There were no independent associations between sarcopenia and clinical and nutritional parameters.
INTRODUCTION: Currently, several international societies recognize the presence of sarcopenia in catabolic diseases, such as chronic kidney disease. Sarcopenia affects quality of life and daily activities of individuals. The aim of this study was to evaluate the diagnosis, prevalence and association of clinical and nutritional parameters with sarcopenia in patients on peritoneal dialysis (PD). METHODS: Screening for sarcopenia was performed in prevalent patients in PD older than 18 years. Muscle mass by appendicular skeletal muscle mass index (ASMMI) and muscle function by handgrip strength (HGS) were evaluated. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP) and its severity was assessed by gait speed (GS). For statistical analysis, Kolmogorov-Smirnov test was used, followed by Chi-square or Fisher's exact test, Mann-Whitney or Student´s t Test, according to data distribution. Later, binary logistic regression was performed. Variables with significance <0.1 in the univariate analysis were included in the binary logistic regression model. RESULTS: Fifty subjects on PD were included, mean age 55.74±16.22 years, 52% female. Sarcopenia prevalence was 10% (n=5), and 8% (n=4) were classified as severe sarcopenia. Comparing the groups of patients according to the presence of sarcopenia, significant differences were found regarding body weight (55.34±7.01kg vs 70.78±15.60kg, p=0.003), body mass index (BMI) (22.75±1.45kg/m² vs 26.35±4.61kg/m², p=0.002), HGS (14.00 (10.5-21.0)kg vs 23.00 (19.0-35.5)kg, p=0.024), ASMMI (6.00 (5.8-6.5)kg/m² vs 7.24 (6.22-8.43)kg/m², p=0.017) and parathyroid hormone (578.00 (419.5-763.00)pg/mL vs 246.00 (186.0-493.5)pg/mL, p=0.027). No associations were observed with the presence of sarcopenia and the predictive variables tested. CONCLUSIONS: Sarcopenia prevalence in patients on PD was 10%. Differences were found between groups in relation to body weight, BMI, HGS, ASMMI and serum PTH levels. There were no independent associations between sarcopenia and clinical and nutritional parameters.
Descrição
Palavras-chave
Nutrição, Doença renal crônica, Diálise peritoneal, Nutrição, Nutrition, Chronic kidney disease, Peritoneal dialysis, Sarcopenia