Multimorbidity and Sarcopenia Feasibility Study in Chronic Kidney Disease

Study Overview
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Brief Summary
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The aim of this research study is to look at the body composition (such as muscle and fat) in people with chronic kidney disease (CKD) and comparing it with body composition is people without CKD. The investigators currently understand loss of muscle function and mass (sarcopenia) affect the general health of people as they age, but this process seems to be more common, accelerated, and occurs earlier in people with CKD. There is limited evidence in this area, and we believe that if we understand when and how sarcopenia affects people with CKD, investigators can guide future trials and treatments to help treat sarcopenia, and in turn improve quality of life and health outcomes in people with CKD.

Detailed Description
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In this study, the investigators will follow up people with CKD in two visits a year apart. In both visits, the investigators will measure the participants body composition and estimated kidney function using 2 different testing methods - Cystatin C eGFR and Creatinine eGFR. Using both the results in a formula, the creatinine muscle index can be calculated. If this index correlated with sarcopenia, it will be helpful tool in the care of people with CKD as will be a easy to use screening tool for sarcopenia in this population.

Official Title
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Multimorbidity and Sarcopenia Feasibility Study in Chronic Kidney Disease

Conditions
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Chronic Kidney Diseases, Sarcopenia

Intervention / Treatment
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* Diagnostic Test: Cystatin C eGFR
* Other: Bioimpedance Analysis (Body composition analysis)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects capable of giving informed consent ≥18 years of age Chronic kidney disease stages 3-5 looked after in secondary care nephrology Healthy volunteers with normal kidney function (Control) Exclusion Criteria: Pregnancy Subjects with known neuromuscular diseases, e.g. myopathy, muscular dystrophy, muscular atrophy Renal transplant recipients Patients with pacemakers

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Healthy volunteers<br>Normal renal function with no kidney disease. Participants with other comorbidities can be included as long as not listed on the exclusion criteria. They will have body composition measured, and eGFR measured. | Diagnostic Test: Cystatin C eGFR<br>* Cystatin C eGFR is not used routinely currently in clinical practice in the UK. It involved a blood test to analyse Cystatin C.<br>Other: Bioimpedance Analysis (Body composition analysis)<br>* Participants will stand on a bioimpedance analysis machine which will measure different components of body composition<br>|
| Chronic Kidney Disease Stage 3<br>People with CKD Stage 3 (eGFR 30-59). They will have body composition measured, and eGFR measured. | Diagnostic Test: Cystatin C eGFR<br>* Cystatin C eGFR is not used routinely currently in clinical practice in the UK. It involved a blood test to analyse Cystatin C.<br>Other: Bioimpedance Analysis (Body composition analysis)<br>* Participants will stand on a bioimpedance analysis machine which will measure different components of body composition<br>|
| Chronic Kidney Disease Stage 4<br>People with CKD 4 (eGFR 15-29). They will have body composition measured, and eGFR measured. | Diagnostic Test: Cystatin C eGFR<br>* Cystatin C eGFR is not used routinely currently in clinical practice in the UK. It involved a blood test to analyse Cystatin C.<br>Other: Bioimpedance Analysis (Body composition analysis)<br>* Participants will stand on a bioimpedance analysis machine which will measure different components of body composition<br>|
| Chronic Kidney Disease Stage 5<br>People with CKD 5 (eGFR <15), but not on dialysis. They will have body composition measured, and eGFR measured. | Diagnostic Test: Cystatin C eGFR<br>* Cystatin C eGFR is not used routinely currently in clinical practice in the UK. It involved a blood test to analyse Cystatin C.<br>Other: Bioimpedance Analysis (Body composition analysis)<br>* Participants will stand on a bioimpedance analysis machine which will measure different components of body composition<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Creatinine Muscle Index (mg/day per 1.73m2) | Product of serum Creatinine and estimated glomerular filtration rate with Cystatin C (eGFRcys) | Day 1 (day recruited) and at 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Skeletal muscle mass (kg) | Measured by Bioimpedance analysis | At Day 1 (day recruited) and 1 year | 
| Multimorbidity Score | The Cambridge Multimorbidity Score is a UK validated index to score the comorbidities of participants. One can score from 0 to 20 on this index. Higher scores are associated with worse clinical outcomes. | Day 1 (day recruited) and 1 year |