Author + information
- Shinsuke Hanatani,
- Masahiro Yamamoto,
- Toshifumi Ishida,
- Satoru Yamamura,
- Yuichi Kimura,
- Satoshi Araki,
- Yasuhiro Izumiya and
- Kenichi Tsujita
Sarcopenia is frequently observed and associated with poor outcomes in patients with chronic kidney disease (CKD). A simple screening test for sarcopenia using age, grip strength, and calf circumference was recently developed. However, the clinical utility of this sarcopenia score in patients with CKD remains unclear.
We calculated sarcopenia score of 265 patients with CKD and followed the patients for cardiovascular events. CKD was defined as estimated glomerular filtration rate less than 60ml/min/1.73m2 and/or the presence of proteinuria by semi-quantitative dipstick test. The endpoint of this study was a composite of total mortality and cardiovascular hospitalization.
We divided all participants into high (n=166) and low (n=99) sarcopenia score groups using a simple scoring system. Patients in the high sarcopenia score group showed significantly higher plasma B-type natriuretic peptide (BNP) levels (median: 103.1 pg/mL, interquartile range: 46.3-310.0 pg/mL) than those in the low sarcopenia score group (median: 46.7 pg/mL, interquartile range: 18.0-91.8 pg/mL) (p<0.0001). The Kaplan-Meier curve revealed that the risk of adverse cardiovascular events was significantly greater in the high than low sarcopenia score group (log-rank test: p<0.0001), even after potential confounding factors were corrected using propensity score matching. Multivariate Cox hazard analysis identified a high sarcopenia score (hazard ratio: 3.00, 95% confidence interval: 1.44-6.27, p=0.0003) as an independent predictor of the primary endpoints. Furthermore, the combination of a high sarcopenia score and high BNP (>200pg/mL) level identified patients with a significantly higher probability of future events (p<0.0001).
This study demonstrates that this simple screening score for sarcopenia could be a useful tool for estimating the future adverse event risk in patients with CKD. This sarcopenia score is convenient and easy to check, and its calculation is useful as a means of risk stratification especially in the primary care setting.
Poster Hall, Hall A/B
Sunday, March 11, 2018, 3:45 p.m.-4:30 p.m.
Session Title: Risk Factor Assessment and Risk Prediction to Guide ASCVD Prevention
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1260-419
- 2018 American College of Cardiology Foundation