Banca de QUALIFICAÇÃO: KAROLINE BÁRBARA DA SILVA OLIVEIRA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : KAROLINE BÁRBARA DA SILVA OLIVEIRA
DATE: 09/01/2023
TIME: 18:30
LOCAL: Google Meet
TITLE:

Sarcopenia as a risk factor for clinical outcomes in patients with chronic kidney disease on hemodialysis.

KEY WORDS:

Sarcopeny. Chronic Kidney Failure. Risk factors. Hospitalization. Mortality. Cardiovascular Diseases.

PAGES: 35
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

INTRODUCTION: Sarcopenia is a muscle pathology (CID-10M62.84), caused by reduced muscle strength and muscle changes added throughout life, being associated with a decline in physical capacity. Sarcopenia and Chronic Kidney Disease (CKD) are progressive and degenerative pathologies, with similar pathophysiology and risk factors. The chronic inflammatory state, increased catabolism, decline in muscle synthesis and increased proteolysis, oxidative stress, metabolic acidosis, accumulation of uremic toxins, in addition to the severe reduction in the level of physical activity, make CKD a potential independent factor for sarcopenia and increased risk for undesirable clinical outcomes. OBJECTIVES: To assess sarcopenia in patients with CKD undergoing hemodialysis (HD) and to investigate its impact as a risk factor for outcomes commonly seen in CKD, such as hospitalizations, the onset of cardiovascular events and mortality. MATERIAL AND METHODS: This is a prospective cohort, carried out with 300 chronic renal patients on HD, from two different units, aged between 18 and 80 years. Sarcopenia was identified through the assessment of muscle strength by Handgrip Strength (HGS) and estimation of muscle mass by corrected Arm Muscle Area (AMBc). Additionally, adductor pollicis muscle thickness (EMAP) and Physical Activity Level (PAL) were assessed using the International Physical Activity Questionnaire (IPAQ). Patients were classified as sarcopenic and without sarcopenia. Data were statistically analyzed using Student's T and Mann-Whitney tests, with significant variables being considered when p<0.05. Patients with sarcopenia were followed up for 8 months to observe the occurrence of the investigated outcomes. RESULTS: Of the participating patients, approximately 63% (189) were men and 37% (111) were women, with a mean age of 51.2±19.2 and duration of HD of 71±75.1 months. Concerning nutritional status, about 47% (141) were eutrophic, followed by overweight patients, 25.3% (76). Approximately 77.7% (223) had reduced HGS and 41.7% (125) had muscle mass depletion by AMBc. Of the evaluated patients, 84.7% (254) were sedentary, with low PAL and 33.7% (101) were diagnosed with sarcopenia. Statistically, patients with normal HGS had better results for BMI, EMAP and AMBc (p<0.05). Accordingly, reduced HGS was associated with lower values of these parameters (p<0.05). Longer HD time and low PAL were significantly related to muscle mass depletion by AMBc (p<0.001). In addition, longer HD time was associated with the diagnosis of sarcopenia (p<0.001) and sarcopenic patients had lower IMC, HGS, EMAP and AMBc values (p<0.001; p=0.025). CONCLUSION: According to the parameters used, it is concluded that patients with CKD on HD have a significant reduction in strength and muscle mass, contributing to the onset of sarcopenia. HD duration and low PAL are significantly associated with a decline in nutritional status and the consequent development of sarcopenia in these patients. It is extremely important to assess sarcopenia in patients with CKD, aiming at the diagnosis and adoption of early therapeutic measures, thus delaying its onset and progression.

BANKING MEMBERS:
Interno(a) - 1791653 - FLAVIO TELES DE FARIAS FILHO
Interno(a) - 3621153 - JULIANA CELIA DE FARIAS SANTOS
Presidente - 2154281 - RODRIGO PEIXOTO CAMPOS