Prevalência e implicações clínicas da sarcopenia e obesidade sarcopênica na doença renal crônica

Abstract

Objective: To describe the prevalence and clinical implications of sarcopenia and sarcopenic obesity (SO) in patients with chronic kidney disease (CKD). Methods: This is an integrative review of articles in English, carried out in MEDLINE via PubMed, from October to December 2021 and considered publications from the last 5 years. Results: 29 studies were selected, 24 on sarcopenia and 5 on SO in CKD. It was observed that the prevalence of sarcopenia and SO in this population ranged from 0.2% to 59.1% and 2% to 23%, respectively. The main clinical implications of sarcopenia were: higher risk of mortality, accelerated progression to the final stage of the disease, worse physical and muscular performance, higher prevalence of falls, reduction of hemoglobin, creatinine, albumin, and serum phosphate, and high values of C-reactive protein (CRP), higher albuminuria, proteinuria, lower serum leptin value, lower bone mineral content, lower estimated glomerular filtration rate (eGFR), higher prevalence of cachexia, higher risk of developing type 2 diabetes mellitus, cardiovascular diseases and depression. The main clinical implications of SO were: higher risk of mortality, worse physical performance, lower eGFR, high concentrations of CRP and serum triglycerides. Conclusion: The prevalence of sarcopenia and SO in individuals with CKD is high, especially in the elderly in the most advanced stages of the disease. The presence of sarcopenia and OS, concomitant with CKD, potentially increases the risk of negative clinical outcomes.