Loop diuretics are associated with greater risk of sarcopenia in patients with non-dialysis-dependent chronic kidney disease

PLoS One. 2018 Feb 15;13(2):e0192990. doi: 10.1371/journal.pone.0192990. eCollection 2018.


Introduction: Sarcopenia, the age-related loss of muscle mass and function, frequently accompanies chronic kidney disease. The aim of this study was to clarify the prevalence and the risk factors for sarcopenia among patients with non-dialysis-dependent chronic kidney disease (NDD-CKD), focusing on the use of drugs.

Methods: We conducted a cross-sectional analysis on a cohort of 260 patients with NDD-CKD in a university hospital, recruited between June 2016 and March 2017. We extracted data on patient gender, age, cause of chronic kidney disease, use of drugs, and comorbidities that could potentially affect the prevalence of sarcopenia. Sarcopenia was diagnosed using the criteria of the Asian Working Group for Sarcopenia. Logistic regression analysis was performed to analyze the association of each factor on the prevalence of sarcopenia.

Results: 25.0% of our study subjects had sarcopenia. Multivariable analysis revealed that an increased risk of sarcopenia was significantly associated with age, male gender, body mass index, diabetes mellitus, and loop diuretic use (odds ratio, 4.59: 95% confidence interval, 1.81-11.61: P-value 0.001).

Conclusions: In our cohort, the prevalence of sarcopenia in patients with NDD-CKD was high, and diuretics use, particularly loop diuretic use, was suggested to be a risk factor of sarcopenia. Although loop diuretics are commonly used in patients with CKD, careful consideration of the risk of sarcopenia may be necessary.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Complications / epidemiology
  • Diabetes Complications / physiopathology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Prevalence
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Factors
  • Sarcopenia / epidemiology*
  • Sarcopenia / physiopathology
  • Sex Factors
  • Sodium Potassium Chloride Symporter Inhibitors / adverse effects
  • Sodium Potassium Chloride Symporter Inhibitors / therapeutic use*


  • Sodium Potassium Chloride Symporter Inhibitors

Grants and funding

This research was supported in part by Grants-in-Aid for Scientific Research (C) (16K09642) to TR from the Japan Society for the Promotion of Science. (https://www.jsps.go.jp/english/e-grants/index.html) The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.