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Causal effects of chronic kidney diseases, renal function, and dialysis on sarcopenia: Insights from a Mendelian

Yehui Zhu, Zhenzhong Chen, Qiankun Zhang

    Clinical Nephrology
    |February 27, 2025
    PubMed

    Insights

    This study found that reduced estimated creatinine-based glomerular filtration rate (eGFRcrea) and dialysis are causally linked to sarcopenia, a condition common in chronic kidney disease patients. These findings highlight key factors contributing to muscle loss in kidney disease.

    Area of Science:

    • Nephrology
    • Geriatrics
    • Genetics

    Background:

    • Sarcopenia is a common complication in patients with chronic kidney disease (CKD), affecting both dialysis and non-dialysis populations.
    • Understanding the causal factors of sarcopenia in CKD is crucial for developing targeted interventions.

    Purpose of the Study:

    • To investigate the causal relationships between CKD, renal function (eGFRcrea and eGFRcys), and dialysis status with sarcopenia.
    • To explore the impact of these factors on specific sarcopenia-related traits such as appendicular lean mass and hand grip strength.

    Main Methods:

    • Utilized a two-sample Mendelian randomization (MR) approach, employing genetic variants from genome-wide association studies (GWAS).
    • Instrumental variables included CKD, eGFRcrea, eGFRcys, and dialysis status.
    • Sarcopenia traits analyzed were appendicular lean mass (ALM), hand grip strength (HGS), and usual walking pace (UWP).

    Main Results:

    • A significant causal effect was observed between decreased eGFRcrea and increased risk of low hand grip strength (HGS) and reduced appendicular lean mass (ALM).
    • Dialysis was also found to be significantly associated with low HGS.
    • No significant causal association was found between eGFRcys or CKD status and sarcopenia.

    Conclusions:

    • Declines in estimated creatinine-based glomerular filtration rate (eGFRcrea) and undergoing dialysis are causally associated with sarcopenia.
    • These findings underscore the importance of monitoring renal function and dialysis status in the context of sarcopenia management in CKD patients.
    Abstract

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