associação da razão ureia-creatinina com a massa muscular, força e capacidade funcional em pacientes com transplante renal

Abstract

INTRODUCTION: Kidney transplant patients (KTP) have decreased muscle mass, strength and functional capacity. The urea/creatinine ratio (UCR) has been used as a marker of muscle catabolism, but it is still unknown whether this ratio is associated with muscle mass and strength in PTR. OBJECTIVE: To associate UCR with strength, muscle mass and functional capacity in PTR. METHODS: A cross-sectional study was carried out with 125 KTPs. Strength was assessed by handgrip strength and the five times sit-to-stand test (FTSST). Appendicular skeletal muscle mass (ASMM) was estimated by electrical bioimpedance. Functional capacity was assessed by the 4- meter gait speed test and short physical performance battery (SPPB). To compare the URC tertiles, one-way analysis of variance (ANOVA) with Tukey's post-hoc test was performed. Nonparametric data were compared using the Kruskal-Wallis test. Data were described as mean and standard deviation or median, interquartile range. Chi square test (χ2) was used to compare data in percentages (categorical variables). Linear regression analysis was performed to assess the association of URC with the components of sarcopenia. The analyzes were performed in model 1 (crude analyses) and model 2 (adjusted analyses). Adjustments were for age, sex, waist circumference (cm), total protein intake (g/kg/d), glomerular filtration rate (ml/min/1.73 m2), corticosteroid use and mTOR inhibitors; transplant time (months) and energy intake (kcal). These same analyzes were performed in subgroups according to GFR (normal versus altered). RESULTS: There was a negative association between URC and handgrip strength in the unadjusted model (β= -0.311, p= 0.001). However, after each variable was adjusted, URC was not associated with handgrip strength (β= -0.128, p= 0.133), FTSST (β= -0.041, p= 0.669), ASMM (β = 0.090, p= 0.354), appendicular muscle mass index (β= 0.024, p= 0.789), walking speed (β= 0.117, p= 0.216) and functional capacity (β= 0.125, p= 0.186). CONCLUSION: URC was not associated with muscle mass, strength and functional capacity in KTP.