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

INTRODUÇÃO: Pacientes com transplante renal (PTR) apresentam diminuição da massa muscular, força e capacidade funcional. A razão ureia/creatinina (RUC) tem sido utilizada como um marcador de catabolismo muscular, mas ainda é desconhecido se esta razão é associada com a massa muscular e força em PTR. OBJETIVO: Associar a RUC com a força, massa muscular e capacidade funcional em PTR. METODOLOGIA: Foi realizado um estudo transversal com 125 PTR. A força foi avaliada pela força de preensão manual e teste de sentar e levantar cinco vezes (TSL5). A massa muscular esquelética apendicular foi estimada por bioimpedância elétrica. A capacidade funcional foi avaliada pelo teste de velocidade de marcha de 4 metros e bateria de desempenho físico curto (BDFC) . RESULTADOS: Houve associação da RUC com a força de preensão manual no modelo sem ajuste. Porém, após cada variável ser ajustada para idade, sexo, circunferência da cintura (cm), ingestão total de proteínas (g / kg / d), taxa de filtração glomerular (ml / min / 1,73m2 ), uso de corticoide e inibidores de mTOR; tempo de transplante (meses) e ingestão energética (kcal), a RUC não foi associada com a força de preensão manual (β= - 0,128, p= 0,133), TSL5 (β= -0,041, p= 0,669), MMA (β= 0,090, p= 0,354), IMMA (β= 0,024, p= 0,789), velocidade de caminhada (β= 0,117, p= 0,216) e capacidade funcional (β= 0,125, p= 0,186). Conclusão: A RUC não foi associada com a massa muscular, força e capacidade funcional em PTR. 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. Dissertação (Mestrado)