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Analysis of muscle strength and bone structure in children with renal disease
K Tenbrock1, S Kruppa, E Mokov
1University of Children's Hospital of Cologne, Germany.
Insights
Children with kidney disease show reduced grip strength, a marker of muscle function. Bone strength, specifically cortical area, correlates with grip strength, suggesting muscle impairment may contribute to bone issues in pediatric renal disease.
Area of Science:
- Pediatric Nephrology
- Bone Metabolism
- Musculoskeletal Health
Background:
- Children with renal disease often experience complications affecting bone structure and muscle strength.
- Previous studies indicate potential links between kidney dysfunction and musculoskeletal abnormalities.
Purpose of the Study:
- To investigate the relationship between bone structure and muscular strength in children with various renal diseases.
- To compare grip strength and bone parameters in children with nephrotic syndrome (NS) and chronic renal failure (CRF) to healthy controls.
Main Methods:
- Peripheral computed tomography (pCT) was used to assess bone structure.
- Grip strength measurements were taken to evaluate muscular strength.
- Participants included children with NS, CRF, and kidney transplants.
Main Results:
- Children with NS and CRF exhibited significantly lower grip strength compared to healthy children.
- A strong positive correlation was found between cortical bone area and grip strength in children with renal disease.
- Trabecular bone mineral density was elevated in children with CRF but did not correlate with grip strength.
Conclusions:
- Grip strength and cortical bone area are well-correlated in pediatric renal disease, similar to healthy children.
- Reduced grip strength in children with renal disease suggests potential muscular impairment.
- Muscular impairment may play a role in the development of renal osteopathy in children.
Abstract:
Bone structure and muscular strength of 30 children with renal disease were investigated by peripheral computed tomography and grip strength. Sixteen children suffered from nephrotic syndrome (NS) and had previously been treated with corticosteroids. Fourteen children suffered from chronic renal failure (CRF) ranging from mild renal failure to end-stage renal disease. Six children had received kidney transplants and corticosteroids for immunosuppression. There was a significant decrease in grip strength of children with NS (SD -0.91+/-1.5; P=0.042) and children with CRF (SD -1.38+/-1.4; P<0.001) compared with normal children. Furthermore, there was a significant correlation between cortical area and grip strength in all children with renal disease (r=0.92; P<0.0001). Trabecular bone mineral density did not correlate well with grip strength. These findings resemble results found in healthy children. Trabecular bone mineral density was significantly elevated in children with CRF compared with normal children (SD 1.14+/-1.4; P=0.008). Grip strength as a marker of muscle mass and cortical area as a marker of bone strength correlate well in children with renal disease, similar to the correlation in healthy children. Grip strength is significantly lower in children with NS and CRF compared with normal children. These data suggest that muscular impairment could be involved in renal osteopathy.