Sarcopenia, an overlooked diagnosis in kidney transplant recipients

Most studies of sarcopenia in renal transplant recipients (RTRs) have been hampered by a lack of standardization in the definitions of sarcopenia. In this study, we aimed to investigate the prevalence of sarcopenia and the associated factors in RTRs using the recently proposed criteria of the European Working Group on Sarcopenia in Older People 2018 (EWGSOP2), which included a standardized definition of sarcopenia. We examined 93 consecutive adult RTRs, 46 chronic kidney disease patients, and 46 healthy controls. We assessed the muscle strength with a hand grip test using a dynamometer and with a chair stand test. We used bioimpedance analysis to estimate appendicular skeletal mass using the Sergi formula. Finally, we conducted a 2-minute walking test to assess endurance. Sarcopenia and probable sarcopenia were determined according to the revised criteria of the EWGSOP2. Probable sarcopenia was found in 29 RTR patients (31.2%), of them 14 (15.1%) were diagnosed with sarcopenia. Multivariate logistic regression analysis showed that presence of diabetes mellitus, increased uric acid level, and statin use were risk factors for probable sarcopenia. On the other hand, longer dialysis vintage was a risk factor for sarcopenia in RTRs. We found that probable sarcopenia and sarcopenia were highly prevalent in our relatively young RTRs. We recommend active screening for the presence of sarcopenia in RTRs, especially in the cadaveric ones. Furthermore, caution seems warranted regarding the myopathic side effects in RTRs who use statins.