Lean tissue mass is associated with adverse outcomes across different stages of chronic kidney disease: a systematic review and meta-analysis
Matthew Tabinor, Emma Elphick, Charlotte Stephens, Nadya Wall, Azm Ul Hussain, Rafeea Shah, Michael Sagmeister, Anna M. Price, Javeria Peracha, Benjamin Anderson, Obaida Istanbuly, James H. Savage, John Belcher, Ivonne Solis-Trapala, Charles J. Ferro, Simon J. Davies
TL;DR
Loss of lean tissue mass is linked to worse outcomes in chronic kidney disease, even after accounting for other health conditions.
Contribution
This study provides the first comprehensive meta-analysis showing that lean tissue mass loss remains a significant risk factor in CKD across various stages.
Findings
Lean tissue mass loss was associated with higher mortality risk in dialysis, CKD, and transplant patients.
Adjusting for multimorbidity did not eliminate the link between lean tissue mass and adverse outcomes.
Lower lean tissue index and phase angle were strongly linked to increased mortality hazard.
Abstract
In chronic kidney disease it is hypothesised that the association between loss of lean tissue mass (LLTM) and mortality is purely a function of multimorbidity. We conducted a systematic review in CKD patients to quantify the strength of association between LLTM and mortality or frailty surrogates, including hospitalisation and quality of life (QoL). Muscle mass was estimated using different whole-body bioimpedance methods (BI-MM). Searches of electronic databases identified 132 studies for inclusion (147542 dialysis patients; 15378 CKDG3−5 patients; 356 kidney transplant recipients [KTR], with 14429 deaths). From 67 studies reporting unadjusted analyses, 52 (78%) demonstrated associations between LLTM and mortality. In 80 studies reporting analyses adjusting for age, sex, and multimorbidity, 59 (74% overall: 74, 67 and 100% in dialysis, CKD, and KTR studies respectively) reported an…
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Taxonomy
TopicsDialysis and Renal Disease Management · Chronic Kidney Disease and Diabetes · Renal Transplantation Outcomes and Treatments