Association of skeletal muscle mass, kidney disease and mortality in older men and women: the cardiovascular health study

Nicholas T. Kruse, Petra Buzkova, Joshua I. Barzilay, Rodrigo J. Valderrabano, John A. Robbins, Howard A. Fink, Diana I. Jalal

Research output: Contribution to journalArticlepeer-review


Low muscle mass (sarcopenia) is a prevalent and major concern in the aging population as well as in patients with chronic kidney disease (CKD). We hypothesized that sarcopenia is an independent predictor of incident and progressive CKD and increased mortality in older men and women (≥65 years) from the Cardiovascular Health Study. Sarcopenia was defined by bioimpedance-estimated skeletal muscle mass index (SMI) as a continuous variable and categorically (normal, class I, and class II). Cox regression hazard ratios (HRs) estimated the risk of incident and prevalent CKD and mortality in individuals with and without CKD. Low SMI was associated with increased prevalence of CKD in men (p<0.001), but lower prevalence of CKD in women (p=0.03). Low muscle mass was not associated with incident CKD or rapid CKD progression (>3 ml/minute/1.73m2/year decline in eGFR) in men, but was associated with lower risk of incident CKD in women ([adjusted RR=0.69, 95% (0.51,0.94)]. Low muscle mass (class II) was independently associated with higher mortality only in men [(adjusted HR=1.26, 95% (1.05,1.50)]. Neither definition of sarcopenia was associated with mortality in men or women with CKD. Further studies are needed to understand the mechanisms by which sarcopenia contributes to higher mortality in aging men.

Original languageEnglish (US)
Pages (from-to)21023-21036
Number of pages14
Issue number21
StatePublished - Nov 2020
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by contracts HHSN26 8201200036C, HHSN268200800007C, HHSN2682018 00001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC8 5086, and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2020. All Rights Reserved.


  • CKD
  • age
  • mortality
  • sarcopenia
  • skeletal muscle index

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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