Urea reduction ratio may predict skeletal muscle mass index for adults on hemodialysis
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Key takeaways:
- Urea reduction ratio was a predictor of skeletal muscle mass index.
- Higher urea reduction ratio percentages correlated with lower skeletal muscle mass index values.
Urea reduction ratio — a metric of hemodialysis efficacy in removing urea — may predict skeletal muscle mass for adults on maintenance hemodialysis, according to research published in the Journal of Renal Nutrition.
“There is an increased risk of skeletal muscle mass loss among patients with stage 5 chronic kidney disease treated with maintenance hemodialysis,” Glenn Brietzke, MS, RD, LD, CNSC, a doctoral student in the department of clinical and preventive nutrition sciences at the Rutgers School of Health Professions in Newark, New Jersey, wrote with colleagues. “The reduced skeletal muscle mass considerably influences the development of protein-energy wasting. Patients who develop protein-energy wasting have higher hospitalization and mortality rates than those without protein-energy wasting.”
Brietzke and colleagues evaluated data from 178 patients on maintenance hemodialysis as part of a secondary analysis of data from the Rutgers Nutrition and Kidney Database. The database includes four studies with patients with kidney disease between 2012 and 2018. In the cross-sectional data, mean age of patients was 55.9 years, 82.9% were Black, 59.1% were men and 39% had obesity.
For the secondary analysis, patients included data available for age, bioelectrical impedance analysis resistance, sex and height. Researchers aimed to identify key skeletal muscle mass index predictors, such as serum albumin, urea clearance normalized treatment ratio, normalized protein catabolic rate, serum creatinine and urea reduction ratio.
Mean skeletal muscle mass of patients was 26.4 kg, and median skeletal muscle mass index was 8.9 kg/m2. Rersearcers also found that the median subjective global assessment score indicated a lower risk of malnutrition.
Urea reduction ratio was a major predictor of skeletal muscle mass index, with higher urea reduction ratio percentages correlated with lower skeletal muscle mass index values.
Brietzke and colleagues confirmed the findings through adjusted regression modeling.
“Research exploring the relationship between urea kinetics and skeletal muscle mass is vital to help better understand early signs of skeletal muscle mass loss to help prevent the development of protein-energy wasting,” they wrote.
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