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Should we consider sarcopenia in pediatric patients with chronic kidney disease? A preliminary cross-sectional

Ana Carolina C Barbosa1, Raquel S Brison1,2, Carolina C Gomes1

  • 1Hospital da Criança de Brasília José Alencar, Brasília, Federal District, Brazil.

Pediatric Nephrology (Berlin, Germany)
|August 11, 2023
PubMed

Insights

Sarcopenia, a muscle-wasting condition, is highly prevalent in pediatric patients with chronic kidney disease (CKD). Early assessment by nephrologists is recommended due to frequent physical impairments and poor nutritional status in these children.

Area of Science:

  • Pediatric Nephrology
  • Clinical Nutrition
  • Musculoskeletal Health

Background:

  • Pediatric patients with chronic kidney disease (CKD) often exhibit suboptimal nutritional status and musculoskeletal deficits.
  • Sarcopenia, characterized by muscle loss, is a growing concern in pediatric CKD populations.
  • Investigating sarcopenia and its associated traits is crucial for understanding the health status of children with CKD.

Purpose of the Study:

  • To investigate the prevalence of sarcopenia and related traits in pediatric patients diagnosed with chronic kidney disease (CKD).
  • To assess physical function and body composition in children and adolescents with CKD.
  • To identify potential associations between sarcopenia indicators and clinical parameters in pediatric CKD.

Main Methods:

  • A cross-sectional study involving pediatric patients (4–17 years) with CKD.
  • Physical function assessed via handgrip strength and 60-second sit-to-stand (STS-60) tests.
  • Body composition evaluated using bioelectrical impedance analysis and mid-upper arm circumference (MUAC); sarcopenia defined by low muscle strength and low MUAC.

Main Results:

  • Fifty-nine percent of pediatric CKD patients showed low handgrip strength, and 100% had impaired STS-60 performance.
  • Seventy-seven percent exhibited low MUAC, with probable sarcopenia in 9% and sarcopenia in 50% of participants.
  • Handgrip strength strongly correlated with MUAC (r=0.90, p<0.001), but STS-60 did not significantly associate with body composition metrics.

Conclusions:

  • High prevalence of sarcopenia and related traits observed in pediatric patients with chronic kidney disease (CKD).
  • Nephrology professionals should consider routine sarcopenia screening in pediatric CKD patients.
  • Further research is necessary to establish the prognostic implications of sarcopenia in this vulnerable population.
Abstract

Keywords:
ChildrenDialysisMuscle massMuscle strengthNutrition

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