Page 187 - Petelin, Ana, ur. 2024. Zdravje delovno aktivnih in starejših odraslih / Health of Working-Age and Older Adults. Zbornik povzetkov z recenzijo ▪︎ Book of Abstracts. Koper: Založba Univerze na Primorskem/University of Primorska Press

Risk Factors of Chronic Kidney Disease Progression

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Mihaela Jurdana , Lucija Brezočnik , Boštjan Žvanut , Bojan Knap 2
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1 University of Primorska Faculty of Health Sciences, Izola, Slovenia
2 University Clinical Centre, Ljubljana, Slovenia
Introduction: The global increase in obesity, sarcopenia and ageing has contributed to
the rise in chronic kidney disease (CKD). Obesity, loss of muscle mass and strength
and sarcopenic obesity (SO) occur in CKD patients and are associated with a poo-
rer clinical prognosis and a higher risk of death. SO is a chronic condition characteri-
sed by the simultaneous presence of muscle wasting and obesity. The prevalence of
SD is due to the ageing of the population and lifestyle changes in recent decades. SD
is often overlooked due to unclear symptoms and poorly defined detection methods,
which can have negative consequences for patients and others. To this end, we exami-
ned muscle mass and strength, the presence of obesity and sarcopenic obesity in hae-
modialysis patients with chronic renal failure.
Methods: The study included 55 male haemodialysis patients aged 60 years and older
with treated at the Department of Nephrology, Department of Acute and Complica-
ted Dialysis, University Hospital Ljubljana. Only patients without active infectious di-
sease and with a glomerular filtration rate (oGF) <10 were included in the study and
divided into two gropu based on their BMI : BMI >25 kg/m and BMI ≤ 25 kg/m .
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Using a bioimpedance body analyser (Akern), we measured the patients‘ body com-
position and monitored fat mass (FM) and fat-free muscle mass (FFM) and calculated posterji | poster presentations
the FM/FFM ratio, as well as the body shape index. Handgrip strength was tested with
a hydraulic dynamometer and muscle function was assessed with a sit-to-stand test.
Biochemical measurements of lipidogram, glucose and C-reactive protein (CRP) we-
re performed and a short validated physical activity questionnaire (NPAQ) was com-
pleted. The study was approved by the National Medical Ethics Committee (KME RS
0120-179/2023).
Results: The group of male patients with a BMI ≥ 25 kg/m had significantly increased
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body and fat mass (FM) (p < 0.001) and waist circumference (p < 0.001). There was
also a significant difference in handgrip strength between the two groups (p < 0.05),
but no significant differences were found between the groups for other parameters.
Systolic blood pressure, blood glucose and triglycerides exceeded the cut-off values
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in the group of patients with a BMI ≥ 25 kg/m , indicating a higher inflammatory sta-
tus in these patients. Patients in both groups did not meet the WHO recommenda-
tions for physical activity, which may have a negative impact on body composition and
overall health. Sarcopenic obesity was found in only one patient. We also found that
the atherogenic index of plasma lipoproteins (AIP) was elevated in male patients with
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a BMI > 25 kg/m .
Conclusions: The results showed a significant association between BMI, body composi-
tion and biochemical measures in patients with CKD, particularly those with a BMI ≥
25 kg/m . Patients in this group have lower muscle mass and strength, higher fat per-
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centage and abdominal circumference, suggesting an inflammatory state, which is an
important factor in the progression of CKD. Based on the results of the questionnaire
and other parameters, it would be useful to regularly monitor patients‘ body weight,
body composition and physical activity, as the parameters related to muscle mass are
lower than expected.
Keywords: sarcopenia, obesity, chronic kidney disease

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