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Chronic Kidney Disease · Journal article
Renal Failure · August 24, 2026
Encouraging direction, but not yet definitive.
In a cross-sectional study of 3,629 community-dwelling older Taiwanese adults aged ≥60 years, underweight status and low calf circumference were independently and jointly associated with sarcopenia and severe sarcopenia across pre-dialysis CKD stages. Combined assessment of these anthropometric measures may improve clinical identification of sarcopenia in older adults with CKD, though causal relationships and optimal cutoff values for calf circumference normalization remain to be established.
Community-based, cross-sectional observational study. Community-dwelling adults aged ≥60 years (mean 72.1 ± 6.12 years; 46.7% men) with pre-dialysis chronic kidney disease. Excluded: dementia, stroke, Parkinson's disease, severe cognitive impairment, disability, cachexia, leg pitting edema grade II or more, missing data, age <60 years.. Intervention: Low calf circumference and underweight status (stratified by body mass index categories per Taiwanese criteria and calf circumference thresholds). Compared with: Normal or overweight BMI with normal calf circumference. n = 3,629. New Taipei City, Taiwan.
Underweight and low calf circumference independently associated with sarcopenia and severe sarcopenia (adjusted OR = 5.47 and 11.60, respectively; p < 0.0001) Low calf circumference associated with significantly higher odds of sarcopenia across all CKD stages G3–5 Significant joint association of underweight and low calf circumference with sarcopenia (adjusted OR = 5.45; p = 0.045)
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Clinicians managing older adults with pre-dialysis CKD may use combined assessment of calf circumference and BMI as a practical screening tool to identify those at risk of sarcopenia. However, this cross-sectional finding does not establish causality and does not provide evidence that intervention on these measures improves clinical outcomes.
Cross-sectional study with sound methodology in a defined population showing clear associations between anthropometric measures and sarcopenia in older adults with CKD, but limited by observational design and lack of temporal or causal inference.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians managing older adults with pre-dialysis CKD may use combined assessment of calf circumference and BMI as a practical screening tool to identify those at risk of sarcopenia. However, this cross-sectional finding does not establish causality and does not provide evidence that intervention on these measures improves clinical outcomes.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Objectives. This community-based, cross-sectional study aimed to evaluate the association of calf circumference and body mass index (BMI) with sarcopenia in older adults with chronic kidney disease (CKD).Methods: Community-dwelling adults aged ≥60 years were enrolled in New Taipei City, Taiwan, between 1 January 2015, and 31 December 2022. CKD status was classified according to Kidney Disease Improving Global Outcomes guidelines, BMI according to Taiwanese criteria, and sarcopenia according to the Asian Working Group for Sarcopenia 2019 consensus. Polytomous and standard logistic regression models were used to estimate odds ratios (ORs) for sarcopenia, adjusting for age, sex, and major comorbidities.Results. A total of 3,629 participants were included (mean age 72.1 ± 6.12 years; 46.7% men). After adjustment, underweight and low calf circumference were independently associated with sarcopenia and severe sarcopenia (adjusted OR = 5.47 and 11.60, respectively; p < 0.0001). Compared with participants with CKD stages G3-5 who had normal or overweight BMI and normal calf circumference, those with low calf circumference had significantly higher odds of sarcopenia across CKD stages. Interaction analysis demonstrated a significant joint association of underweight and low calf circumference with sarcopenia in CKD (adjusted OR = 5.45; p = 0.045).Conclusions. Low calf circumference and underweight were independently and jointly associated with sarcopenia in community-dwelling older adults with pre-dialysis CKD. Combined assessment of calf circumference and BMI may facilitate sarcopenia identification in older adults with CKD. However, body size may influence this association, warranting further studies on optimal calf circumference normalization.
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