Understanding Sarcopenia in CKD: The Role of Inflammation, Metabolic Dysfunction, and Frailty

A new study published in the British Medical Journal showed that sarcopenia, the gradual decline in both muscle mass and performance, is a significant but often overlooked issue in individuals suffering from Chronic Kidney Disease (CKD).

Sarcopenia is a condition affecting skeletal muscles, marked by diminished muscle strength, decreased muscle mass, and hindered physical abilities. It is becoming more acknowledged in individuals with CKD and is linked to negative health consequences. Nonetheless, there is a lack of sufficient data on sarcopenia in CKD patients in Ethiopia. Consequently, this research was set to evaluate how common sarcopenia is and the factors related to it in adult CKD patients receiving care at a tertiary hospital in Northwest Ethiopia.

From September to November 2022, a cross-sectional study took place at Felege Hiwot Comprehensive Specialized Hospital, focusing on adult CKD patients at the renal clinic. All suitable patients were included consecutively. The evaluation of sarcopenia followed the European Working Group on Sarcopenia in Older People 2 guidelines, which involved assessing muscle strength, muscle mass, and physical performance. Data on demographics, health status, body measurements, and blood tests were gathered using specific tools and lab tests. 

In this study, 120 consecutive patients with CKD were examined, with 60 individuals having end-stage renal disease (ESRD) and the other 60 without ESRD. Among those without ESRD, 5 (8.3%), 13 (21.7%), 26 (43.3%), and 16 (26.7%) were categorized into CKD stages 1, 2, 3, and 4, respectively. The prevalence of sarcopenia was notably higher in patients with ESRD when compared to those without ESRD (28.3% vs. 10.0%, p=0.01). The distribution of sarcopenia stages also varied significantly between the two groups (p=0.02).

In a comprehensive analysis, low high-density lipoprotein, high triacylglycerol, elevated fasting blood glucose, hypertension, and frailty were found to be significantly linked to sarcopenia. Additionally, sarcopenia was significantly associated with creatinine (r=−0.291, p=0.001), estimated glomerular filtration rate (r=0.260, p=0.004), frailty (r=0.566, p<0.001), malondialdehyde (r=−0.392, p<0.001), and total antioxidant capacity (r=0.455, p<0.001).

Overall, sarcopenia is common among patients with chronic kidney disease, especially those with end-stage renal disease, and is closely linked to inflammation, oxidative stress, metabolic irregularities, frailty, and liver issues. These results highlight the importance of timely detection and comprehensive treatment plans focusing on changeable factors to lessen the impact of sarcopenia in chronic kidney disease groups.

Source:

Agidew, M. M., & Derso, G. (2026). Sarcopenia among chronic kidney disease patients attending a renal clinic in Northwest Ethiopia: a cross-sectional study of prevalence, risk factors and clinical implications. BMJ Open, 16(9), e123421. https://doi.org/10.1136/bmjopen-2026-123421