High prevalence of sarcopenia, osteoporosis and osteosarcopenia in patients with chronic kidney disease compared with healthy controls

Summary: Brief rationale: The impact of non-dialysis chronic kidney disease (CKD) on combined muscle and bone decline remains insufficiently described. Main result: Patients with CKD showed markedly higher rates of sarcopenia, osteoporosis, and osteosarcopenia than matched healthy controls. Significance of the paper: These findings support systematic evaluation of muscle and bone health in CKD management. Purpose: Chronic kidney disease (CKD) negatively affects bone and muscle quality. The combination of sarcopenia and osteoporosis, osteosarcopenia, is associated with an increased risk of fractures and mortality. Yet, little is known about osteosarcopenia in patients with non-dialysis-dependent CKD compared to healthy controls. We hypothesized that patients with CKD have a higher prevalence of osteosarcopenia than healthy adults. Methods: In this cross-sectional study, 138 patients with CKD stages G4-5 were matched 1:1 on sex and age to healthy controls. We assessed appendicular lean mass and bone mineral density (BMD) at the hips and lumbar spine using dual-energy X-ray absorptiometry and evaluated muscle strength through handgrip strength, 30-s chair stands, and 10-m gait speed. Sarcopenia was defined using the criteria by the EWGSOP criteria, osteoporosis by the WHO criteria, and osteosarcopenia required the presence of both. Results: CKD participants had weaker handgrip strength, poorer chair-stand performance, and slower gait speed compared to healthy controls. BMD was reduced in patients with CKD. The prevalence of sarcopenia (21.7% vs. 5.8%; OR 4.51 [1.91–11.8]), osteoporosis (21.7% vs. 10.1%; OR 2.44 [1.25–4.99]), and osteosarcopenia (8.7% vs 1.4%; OR 6.44 [1.39–60.4]) were higher in patients with CKD compared to controls. Conclusion: In this cross-sectional study, there was a higher prevalence of sarcopenia, osteoporosis, and osteosarcopenia in patients with CKD as compared to sex- and age-matched healthy controls. These findings indicate that it is relevant with a systematic assessment of muscle and bone health in CKD management.