Sarcopenia da pessoa idosa com doença renal crônica e sua associação com a taxa de filtração glomerular

Abstract

INTRODUCTION: The global aging of the population raises concerns about the degradation of tissues and body functions, such as muscle metabolism, which can lead to the development of sarcopenia, a condition that can appear primarily, but can also be related to chronic diseases such as Chronic Kidney Disease (CKD). In the case of assessing renal function in elderly people, the lack of an adequate equation to estimate GFR in elderly people is a limitation found in the literature, with the point being that the BIS1 formula would be the most appropriate, as it was developed with people aged over 70 years. OBJECTIVE: The present study aimed to identify the presence of sarcopenia and other changes in the physical capacity of elderly people with CKD and their correlations with the glomerular filtration rate (GFR), as well as to evaluate the performance of the CKD-EPI, Cockcroft formulas -Gault, MDRD and BIS, suggested by KDIGO to estimate GFR, also correlating the GFR estimated by the formulas used with the sarcopenia diagnostic variables and other nutritional status assessment data. MATERIALS AND METHODS: This was a cross-sectional study with elderly people with CKD, collecting socioeconomic, demographic, clinical, anthropometric, laboratory and sarcopenia data according to the criteria of the European Working Group on Sarcopenia in Older People – EWGSOP (2019) and GFR was calculated using the CKD-EPI, Cockcroft-Gault, MDRD and BIS1 formulas. The statistical analysis compared the groups with the Student's t test, chi-square test, Fisher's test, simple linear regressions and adjusted for sex, in addition to Cohen's kappa, all using the IBM SPSS version 21 software, adopting an alpha value of 5%. RESULTS: Sarcopenia was detected in 24.61% of individuals. However, 53.84% of patients had low handgrip strength, and 30.80% had low muscle mass, which, together with low hemoglobin levels, were data positively associated with GFR. When comparing the formulas, CKD-EPI showed better similarity with BIS1 and the variables strength and hemoglobin levels were directly related to GFR levels. CONCLUSION: The EWGSOP2 guideline was not very sensitive for diagnosing sarcopenia in the studied population, however, there was a positive correlation between strength and hemoglobin with GFR, even when comparing the performance of the formulas. The use of the BIS1 and CKDEPI equations is suggested to monitor the renal function of elderly people, requiring greater monitoring of this population, both in relation to the muscular profile and in relation to renal function.