Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/66001
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Type: Journal article
Title: Investigation of skeletal muscle quantity and quality in end-stage renal disease
Author: Cheema, B.
Abas, H.
Smith, B.
O'Sullivan, A.
Chan, M.
Patwardhan, A.
Kelly, J.
Gillin, A.
Pang, G.
Lloyd, B.
Berger, K.
Baune, B.
Fiatarone-Singh, M.
Citation: Nephrology, 2010; 15(4):454-463
Publisher: Blackwell Publishing Asia
Issue Date: 2010
ISSN: 1320-5358
1440-1797
Statement of
Responsibility: 
Birinder Cheema, Haifa Abas, Benjamin Smith, Anthony J O’Sullivan, Maria Chan, Aditi Patwardhan, John Kelly, Adrian Gillin, Glen Pang, Brad Lloyd, Klaus Berger, Bernhard T Baune and Maria Fiatarone Singh
Abstract: AIM: A more precise understanding of the aetiology and sequelae of muscle wasting in end-stage renal disease (ESRD) is required for the development of effective interventions to target this pathology. METHODS: We investigated 49 patients with ESRD (62.6 +/- 14.2 years, 0.3-16.7 years on haemodialysis). Thigh muscle cross-sectional area (CSA), intramuscular lipid and intermuscular adipose tissue (IMAT) were measured via computed tomography as indices of muscle quantity (i.e. CSA) and quality (i.e. intramuscular lipid and IMAT). Additional health and clinical measures were investigated to determine associations with these variables. RESULTS: Age, energy intake, disease burden, pro-inflammatory cytokines, nutritional status, strength and functioning were related to muscle quantity and quality. Potential aetiological factors entered into forward stepwise regression models indicated that hypoalbuminaemia and lower body mass index accounted significantly and independently for 32% of the variance in muscle CSA (r = 0.56, P < 0.001), while older age and interleukin-8 accounted for 41% of the variance in intramuscular lipid (r = 0.64, P < 0.001) and body mass index accounted for 45% of the variance in IMAT (r = 0.67, P < 0.001). Stepwise regression models revealed that intramuscular lipid was independently predictive of habitual gait velocity and 6 min walk distance, while CSA was independently predictive of maximal isometric strength (P < 0.05). CONCLUSION: Ageing, poor nutritional status and elevated interleukin-8 are factors potentially contributing to the loss of muscle quality and quantity in ESRD. These deficits can predict functional impairments, with intramuscular lipid accumulation most closely related to decline of submaximal musculoskeletal performance (walking), and low muscle CSA most closely related to decline of maximal performance (peak isometric strength).
Keywords: attenuation; cytokines; diabetes; insulin resistance; obesity; quality of life.
Rights: © 2009 The Authors. Journal compilation © 2009 Asian Pacific Society of Nephrology
RMID: 0020111383
DOI: 10.1111/j.1440-1797.2009.01261.x
Appears in Collections:Psychiatry publications

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