Kidney function as a predictor of loss of lean mass in older adults: health, aging and body composition study.
OBJECTIVE
To assess the association between kidney function and change in body composition in older individuals.


METHODS
Prospective cohort study.


METHODS
Two sites, Pittsburgh, Pennsylvania, and Memphis, Tennessee.


METHODS
Three thousand twenty-six well-functioning, participants aged 70 to 79 in the Health, Aging and Body Composition Study.


METHODS
Body composition (bone-free lean mass and fat mass) was measured using dual x-ray absorptiometry annually for 4 years. Kidney function was measured at baseline according to serum creatinine (SCr). Comorbidity and inflammatory markers were evaluated as covariates in mixed-model, repeated-measures analysis.


RESULTS
High SCr was associated with loss of lean mass in men but not women, with a stronger relationship in black men (P=.02 for difference between slopes for white and black men). In white men, after adjustment for age and comorbidity, higher SCr remained associated with loss of lean mass (-0.07+/-0.03 kg/y greater loss per 0.4 mg/dL (1 standard deviation (SD)), P=.009) but was attenuated after adjustment for inflammatory factors (-0.05+/-0.03 kg/y greater loss per SD, P=.10). In black men, the relationship between SCr and loss of lean mass (-0.19+/-0.04 kg/y per SD, P<.001) persisted after adjustment for inflammation and overall weight change.


CONCLUSIONS
Impaired kidney function may contribute to loss of lean mass in older men. Inflammation appeared to mediate the relationship in white but not black men. Future studies should strive to elucidate mechanisms linking kidney disease and muscle loss and identify treatments to minimize loss of lean mass and its functional consequences.
Fried
Linda F
LF
Renal Section, Veterans Affairs Pittsburgh Healthcare System Pittsburgh, Pennsylvania 15240, USA. Linda.Fried@va.gov
Boudreau
Robert
R
Lee
Jung Sun
JS
Chertow
Glenn
G
Kurella-Tamura
Manjula
M
Shlipak
Michael G
MG
Ding
Jingzhong
J
Sellmeyer
Deborah
D
Tylavsky
Frances A
FA
Simsonick
Eleanor
E
Kritchevsky
Stephen B
SB
Harris
Tamara B
TB
Newman
Anne B
AB
D001741:Black or African American; D000368:Aged; D000375:Aging / Q000502:physiology*; D001823:Body Composition; D003404:Creatinine / Q000097:blood; D005260:Female; D005853:Geriatrics; D006306:Health Surveys; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D011446:Prospective Studies; D012737:Sex Factors; D044465:White People
D003404:Creatinine