A saúde muscular pode influenciar na anemia de pacientes em hemodiálise?
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.212151Palabras clave:
Eritrócitos, Diálise, Ferro, Músculo esquelético, hemoglobinaResumen
Introdução: No paciente com doença renal crônica (DRC) ocorrem complicações decorrentes da doença avançada e tratamento, como a anemia e alterações musculoesqueléticas. Ambas as condições podem inter-relacionarem e associarem a desfechos negativos. Objetivo: avaliar a associação da anemia com a sarcopenia e seus componentes, força e massa muscular, em pacientes com DRC em hemodiálise (HD). Métodos: Trata-se de um estudo transversal com pacientes em HD crônica, de ambos os sexos. Foram coletados dados sociodemográficos, laboratoriais, clínicos, antropométricos e força de preensão manual. A sarcopenia foi diagnosticada de acordo com os critérios do European Working Group on Sarcopenia in Older People 2. Os pacientes foram comparados de acordo com a presença e ausência de anemia e as variáveis categóricas analisadas pelo teste do Qui-quadrado de Pearson ou exato de Fisher. Foi aplicado um modelo de regressão logística multivariada utilizando a presença de anemia como variável dependente. Resultados: A amostra foi composta por 116 pacientes, com média de idade de 58 ±12,2 anos, sendo 68,1% do sexo masculino. Foi observado que 66,4% dos pacientes não apresentaram sarcopenia, 18,1% foram diagnosticados com provável sarcopenia e 15,5% com sarcopenia. A sarcopenia foi associada a idade, comorbidades, índice de massa corporal e hemoglobina. A anemia foi diagnosticada em 84,5% dos indivíduos e foi associada à sarcopenia (p<0,05), mas não aos seus componentes. A sarcopenia provável (OR 6,1; IC 95%: 1,4-26,3;
p=0,015) e confirmada (OR 12,9; IC 95%: 1,3-130,9; p=0,030) elevaram as chances de anemia. Conclusões: A relação entre anemia e sarcopenia foi confirmada em pacientes em HD crônica, sugerindo que a sarcopenia pode se associar ocorrência de anemia.
Descargas
Referencias
Marinho AWGB, Penha A da P, Silva MT, Galvão TF. Prevalência de doença renal crônica em adultos no Brasil: revisão sistemática da literatura. Cad Saude Colet. 2017 Oct 9;25(3):379–88.
Ammirati AL. Chronic Kidney Disease. Rev Assoc Med Bras. 2020;66(suppl 1):s03–9.
Romagnani P, Remuzzi G, Glassock R, Levin A, Jager KJ, Tonelli M, et al. Chronic kidney disease. Vol. 3, Nature Reviews Disease Primers. Nature Publishing Group; 2017.
Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. American Journal of Kidney Diseases. 2020;76(3).
Chan W. Chronic Kidney Disease and Nutrition Support. Nutrition in Clinical Practice. 2021 Apr 18;36(2):312–30.
Chen TK, Knicely DH, Grams ME. Chronic Kidney Disease Diagnosis and Management. JAMA. 2019 Oct 1;322(13):1294.
Who, Chan M. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva, Switzerland: World Health Organization. 2011;
Hanna RM, Streja E, Kalantar-Zadeh K. Burden of Anemia in Chronic Kidney Disease: Beyond Erythropoietin. Advances in Therapy 2020 38:1 [Internet]. 2020 Oct 29 [cited 2023 May 8];38(1):52–75. Available from: https://link.springer.com/article/10.1007/s12325-020-01524-6
Pfeffer MA, Burdmann EA, Chen CY, Cooper ME, de Zeeuw D, Eckardt KU, et al. A Trial of Darbepoetin Alfa in Type 2 Diabetes and Chronic Kidney Disease. New England Journal of Medicine. 2009;361(21).
Provenzano M, Vecchio L Del, Lecco A, Minutolo R, Martín L, Portolés J, et al. Anemia in Chronic Kidney Disease: From Pathophysiology and Current Treatments, to Future Agents. Frontiers in Medicine [Internet]. 2021 [cited 2023 May 8];1:642296. Available from: www.frontiersin.org
Gregg LP, Bossola M, Ostrosky-Frid M, Hedayati SS. Fatigue in CKD. Clinical Journal of the American Society of Nephrology. 2021 Sep;16(9):1445–55.
Li C wei, Yu K, Shyh-Chang N, Jiang Z, Liu T, Ma S, et al. Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. Vol. 13, Journal of Cachexia, Sarcopenia and Muscle. 2022.
Cruz-Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, Boirie Y, et al. Prevalence of and interventions for sarcopenia in ageing adults: A systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014;43(6).
Yuan S, Larsson SC. Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism. 2023 Jul;144:155533.
Picca A, Calvani R. Molecular mechanism and pathogenesis of sarcopenia an overview. Vol. 22, International Journal of Molecular Sciences. 2021.
Nakamura K, Yoshida D, Honda T, Hata J, Shibata M, Hirakawa Y, et al. Prevalence and mortality of sarcopenia in a community-dwelling older japanese population: The hisayama study. J Epidemiol. 2021;31(5):320–7.
Balducci L. Anemia, fatigue and aging. Transfusion Clinique et Biologique. 2010 Dec;17(5–6):375–81.
Penninx BWJH, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, et al. Anemia Is Associated with Disability and Decreased Physical Performance and Muscle Strength in the Elderly. J Am Geriatr Soc. 2004;52(5).
Gadelha AB, Cesari M, Corrêa HL, Neves RVP, Sousa CV, Deus LA, et al. Effects of pre-dialysis resistance training on sarcopenia, inflammatory profile, and anemia biomarkers in older community-dwelling patients with chronic kidney disease: a randomized controlled trial. Int Urol Nephrol. 2021;53(10).
Atkinson MA, Warady BA. Anemia in chronic kidney disease. Vol. 33, Pediatric Nephrology. Springer Verlag; 2018. p. 227–38.
Provenzano M, Vecchio L Del, Lecco A, Minutolo R, Martín L, Portolés J, et al. Anemia in Chronic Kidney Disease: From Pathophysiology and Current Treatments, to Future Agents EPIDEMIOLOGY OF ANEMIA OF CKD. Frontiers in Medicine | www.frontiersin.org [Internet]. 2021 [cited 2023 May 8];1:642296. Available from: www.frontiersin.org
Dhillon RJS, Hasni S. Pathogenesis and Management of Sarcopenia. Vol. 33, Clinics in Geriatric Medicine. 2017.
Cho MR, Lee S, Song SK. A Review of Sarcopenia Pathophysiology, Diagnosis, Treatment and Future Direction. J Korean Med Sci. 2022;37(18).
Associação Brasileira de Empresas de Pesquisa (ABEP). Critério de Classificação Econômica Brasil (CCEB). 2021;
Organisation WH. Obesity: preventing and managing the global epidemic-results of a WHO consultation on obesity. Geneva, WHO. 1997;WHO/NUT/NC.
Lipschitz DA. Screening for nutritional status in the elderly. Vol. 21, Primary Care - Clinics in Office Practice. 1994.
Barbosa-Silva TG, Bielemann RM, Gonzalez MC, Menezes AMB. Prevalence of sarcopenia among community-dwelling elderly of a medium-sized South American city: results of the COMO VAI ? study. J Cachexia Sarcopenia Muscle. 2016 May;7(2):136–43.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16–31.
Dodds RM, Syddall HE, Cooper R, Benzeval M, Deary IJ, Dennison EM, et al. Grip strength across the life course: Normative data from twelve British studies. PLoS One. 2014;9(12).
Bevilacqua JL, Canziani ME ugênia F. Monitoring of hematimetric parameters. J Bras Nefrol. 2014;36(1).
Ribeiro-Alves MA lmerinda, Gordan PA lejandro. Diagnosis of anemia in patients with chronic kidney disease. J Bras Nefrol. 2014;36(1).
Weir MR. Managing Anemia across the Stages of Kidney Disease in Those Hyporesponsive to Erythropoiesis-Stimulating Agents. Am J Nephrol. 2021;52(6).
Drüeke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, et al. Normalization of Hemoglobin Level in Patients with Chronic Kidney Disease and Anemia. New England Journal of Medicine. 2006;355(20).
Antunes de Mattos B, Mariano da Rocha Silla L, Corrêa Krug B, Beatriz Treter Gonçalves C, Medeiros Amaral K, Costa Xavier L, et al. Protocolo Clínico e Diretrizes Terapêuticas - Anemia por deficiência de ferro. Portaria SAS/MS no 1247, de 10 de novembro de 2014. 2014;
Joshwa B, Campbell ML. Fatigue in Patients with Chronic Kidney Disease: Evidence and Measures. Vol. 44, Nephrology nursing journal : journal of the American Nephrology Nurses’ Association. 2017.
Joosten E, Detroyer E, Milisen K. Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients. BMC Geriatr. 2016 Aug 19;16(1).
Gi YM, Jung B, Kim KW, Cho JH, Ha IH. Low handgrip strength is closely associated with anemia among adults: A cross-sectional study using Korea National Health and Nutrition Examination Survey (KNHANES). PLoS One. 2020;15(3).
da Silva V, Corrêa H, Neves R, Deus L, Reis A, Souza M, et al. Impact of Low Hemoglobin on Body Composition, Strength, and Redox Status of Older Hemodialysis Patients Following Resistance Training. Front Physiol. 2021 Mar 10;12.
Esteva S, Panisello P, Casas M, Torrella JR, Pagés T, Viscor G. Morphofunctional responses to anaemia in rat skeletal muscle. J Anat. 2008;212(6).
McFarlane SI, Chen SC, Whaley-Connell AT, Sowers JR, Vassalotti JA, Salifu MO, et al. Prevalence and Associations of Anemia of CKD: Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999-2004. American Journal of Kidney Diseases. 2008 Apr;51(4):S46–55.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing. 2010 Jul 1;39(4):412–23.
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2024 Afonso Marcos Alves de Souza; Joyce Regina Oliveira Segati Costa, Maria Claudia Bernardes Spexoto; Flávia Andréia Marin
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
