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Andrade FP, Borges S, da Silva Filho CA, Martins TF, Benvenutti H, de Freitas JDMC, Thomé FS, Karohl C, Souza GC, Cipriano GFB, Rovedder PME. Respiratory sarcopenia screening in dialysis patients: cross-sectional and multicentre study protocol. BMC Nephrol 2024; 25:41. [PMID: 38287281 PMCID: PMC10826040 DOI: 10.1186/s12882-023-03390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Respiratory sarcopenia is characterized by the weakness of respiratory muscles associated with sarcopenia due to aging or systemic diseases such as chronic kidney disease (CKD). Patients with CKD undergoing dialysis are particularly susceptible to respiratory muscle weakness caused by factors such as fluid overload and electrolyte imbalance. This weakness not only affects ventilation but also impairs oxygen uptake and delivery to muscle tissue, potentially leading to severe sarcopenia. Thus, the objective of this study is to conduct a respiratory sarcopenia screening in patients with CKD undergoing haemodialysis (HD) and peritoneal dialysis (PD). METHODS This is an observational, cross-sectional and multicentre study conducted between March 2023 and March 2025. The study was approved by the Research Ethics Committee at two centres. Sarcopenia diagnosis is determined based on low handgrip strength and amount of appendicular skeletal muscle mass, assessed through bioelectrical impedance analysis. Respiratory sarcopenia is diagnosed in patients with sarcopenia who have low inspiratory muscle strength, evaluated through a manovacuometry test. The severity of sarcopenia and respiratory sarcopenia is defined, respectively, by low physical performance (measured using the Short Physical Performance Battery and Timed-Up and Go test) and pulmonary performance (measured through spirometry). Thus, this study will include 81 patients undergoing dialysis (41 on HD and 40 on PD) from three participating centres. DISCUSSION The literature has been focused on respiratory function in CKD; however, the relationship with sarcopenia remains understudied. We believe that, similar to appendicular skeleton muscles, the axial skeleton muscles are also likely to weaken with the presence of chronic disease, such as CKD.
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Affiliation(s)
- Francini Porcher Andrade
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil.
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
- Research Center in Sports Sciences, Health Sciences and Human Development, University of Maia (CIDESD-UMAIA), Maia, Portugal.
| | - Sheila Borges
- Science and Technology in Health Programme, University of Brasília (UnB), Brasília, Distrito Federal, Brazil
| | - César Alencar da Silva Filho
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Taís Ferreira Martins
- Sciences of Rehabilitation Post-Graduation Programme, University of Brasília (UnB), Brasilia, Distrito Federal, Brazil
| | - Heloíse Benvenutti
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Júlia de Melo Cardoso de Freitas
- Medical Sciences Focused on Endocrinology Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Saldanha Thomé
- Faculty of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Instituto de Doenças Renais (IDR), Porto Alegre, Rio Grande do Sul, Brazil
| | - Cristina Karohl
- Faculty of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Correa Souza
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Graziella França Bernardelli Cipriano
- Science and Technology in Health Programme, University of Brasília (UnB), Brasília, Distrito Federal, Brazil
- Sciences of Rehabilitation Post-Graduation Programme, University of Brasília (UnB), Brasilia, Distrito Federal, Brazil
| | - Paula Maria Eidt Rovedder
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Forcellini Pedrollo E, Bellincanta Nicoletto B, Salomoni Carpes L, de Melo Cardoso de Freitas J, Buboltz JR, Carra Forte C, Bauer AC, Ceratti Manfro R, Corrêa Souza G, Bauermann Leitão C. Effect of an intensive nutrition intervention of a high protein and low glycemic-index diet on weight of kidney transplant recipients: study protocol for a randomized clinical trial. Trials 2017; 18:413. [PMID: 28874181 PMCID: PMC5585938 DOI: 10.1186/s13063-017-2158-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 08/21/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Excessive weight gain is commonly observed within the first year after kidney transplantation and is associated with negative outcomes, such as graft loss and cardiovascular events. The purpose of this study is to evaluate the effect of a high protein and low glycemic-index diet on preventing weight gain after kidney transplantation. METHODS We designed a prospective, single-center, open-label, randomized controlled study to compare the efficacy of a high protein (1.3-1.4 g/kg/day) and low-glycemic index diet versus a conventional diet (0.8-1.0 g/kg/day of protein) on preventing weight gain after kidney transplantation. A total of 120 eligible patients 2 months after transplantation will be recruited. Patients with an estimated glomerular filtration rate through the modification of diet of renal disease (MDRD) formula < 30 mL/min/1.73 m2 or urinary albumin excretion > 300 mg/24 h will be excluded. Patients' diets will be allocated through simple sequential randomization. Patients will be followed-up for 12 months with nine clinic appointments with a dietitian and the evaluations will include nutritional assessment (anthropometrics, body composition, and resting metabolic rate) and laboratory tests. The primary outcome is weight maintenance or body weight gain under 5% after 12 months. Secondary outcomes include body composition, resting metabolic rate, satiety sensation, kidney function, and other metabolic parameters. DISCUSSION Diets with higher protein content and lower glycemic index may lead to weight loss because of higher satiety sensation. However, there is a concern about the association of high protein intake and kidney damage. Nevertheless, there is little evidence on the impact of high protein intake on long-term kidney function outcome. Therefore, we designed a study to test if a high protein diet with low-glycemic index will be an effective and safe nutritional intervention to prevent weight gain in kidney transplant patients. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT02883777 . Registered on 3 August 2016.
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Affiliation(s)
- Elis Forcellini Pedrollo
- Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
| | - Bruna Bellincanta Nicoletto
- Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
- Nutrition Course, Knowledge Area of Life Sciences, Universidade de Caxias do Sul, Caxias do Sul, RS Brazil
| | - Larissa Salomoni Carpes
- Nutrition Graduate Course, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil
| | | | - Julia Roberta Buboltz
- Nutrition Graduate Course, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil
| | - Cristina Carra Forte
- Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
| | - Andrea Carla Bauer
- Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
- Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
| | - Roberto Ceratti Manfro
- Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
- Post Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
| | - Gabriela Corrêa Souza
- Department of Nutrition, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
- Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre (HCPA-UFRGS), Porto Alegre, RS Brazil
| | - Cristiane Bauermann Leitão
- Post Graduate Program in Health Sciences, Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
- Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-003 Porto Alegre, RS Brazil
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