Dynamic assessment of the filtration function of the kidneys and indicators of muscle mass in patients with sarcopenia and chronic heart failure

Abstract

Currently, due to the increase in life expectancy in the human population, the relevance of the problem of sarcopenia and chronic somatic pathology, including chronic heart failure (CHF), is increasing. At the same time, there are no clear recommendations for managing patients with a combination of CHF and sarcopenia. In addition, the impact of sarcopenia in combination with CHF on kidney filtration function remains poorly understood. The aim of the study was to evaluate the dynamics of muscle mass and strength, kidney filtration function in patients with sarcopenia and CHF in a longitudinal study involving 53 male patients with a mean age of 75.2 ± 7.3 years. The first (main) group (n = 24) consisted of patients with CHF and sarcopenia, while the second comparison group (n = 29) included patients with CHF without sarcopenia. The results showed that patients in the main group had a more pronounced decrease in muscle mass and strength over time, glomerular filtration rate (GFR), calculated using CKD-EPI formulas, based on cystatin C (CKD-EPICysC) and cystatin-creatinine (CKD-EPICysC+Cr) levels. In the comparison group, a more significant decrease in GFR, calculated using creatinine, was observed. It is emphasized that for more accurate determination of GFR in patients with CHF and accompanying sarcopenia, it is advisable to use the CKD-EPICysC formula. Future controlled randomized studies will determine the possibility of including this recommendation in appropriate protocols for managing elderly patients.