Muscle wasting carries increased risk of CKD progression in diabetic Asians

Among Asian patients with type 2 diabetes (T2D), those with low baseline skeletal muscle mass and who show a decline over time are at heightened risk of progression to chronic kidney disease (CKD), according to a study.

In total, 1,272 T2D patients participated in the prospective cohort study. Skeletal muscle mass was measured using tetra-polar multifrequency bio-impedance analysis, with Skeletal Muscle Mass Index (SMI) defined as skeletal muscle mass/weight*100.

Over up to 8 years of follow-up, 33.3 percent of patients progressed to CKD and 28.3 percent had albuminuria progression.

Multivariable Cox analysis revealed an inverse association with SMI and the outcomes. Specifically, each 1-standard deviation increase in baseline SMI translated to an 18-percent reduction in the risk of CKD progression (hazards ratio [HR], 0.82, 95 percent confidence interval [CI], 0.70–0.97; p=0.018) and a 17-percent decrease in the risk of albuminuria progression (HR, 0.83, 95 percent CI, 0.71–0.97; p=0.017).

Compared with those who showed the smallest change from baseline in SMI (tertile 2), patients with the largest decrease in SMI over time had a 67-percent higher risk of CKD progression (HR, 1.67, 95 percent CI, 1.10–2.55; p=0.016).

Further analysis showed that pigment epithelium-derived factor (PEDF) and plasma leucine-rich α-2-glycoprotein (LRG1) accounted for 40.1 percent of the association between SMI and CKD progression.