{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:16:32Z","timestamp":1790662592680,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Post\u2010transplant anaemia and reduced muscle mass and strength are highly prevalent in kidney transplant recipients (KTRs). Decreased haemoglobin levels, a marker of anaemia, could adversely affect muscle mass and strength through multiple mechanisms, among others, through diminished tissue oxygenation. We aimed to investigate the association between haemoglobin levels with muscle mass and strength in KTRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included stable KTRs from the TransplantLines Biobank and Cohort study with a functional graft \u22651\u00a0year post\u2010transplantation. Muscle mass was assessed using 24\u00a0h urinary creatinine excretion rate (CER) and bioelectrical impedance analysis (BIA). Muscle strength was assessed with a handgrip strength test using a dynamometer and, in a subgroup (<jats:italic>n<\/jats:italic>\u00a0=\u00a0290), with the five\u2010times sit\u2010to\u2010stand (FTSTS) test. We used multivariable linear and logistic regression analyses to investigate the associations of haemoglobin levels with muscle mass and strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 871 included KTRs [median age 58 (interquartile range (IQR), 48\u201366)] years; 60% men; eGFR 51\u00a0\u00b1\u00a018\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>) who were 3.5 (1.0\u201310.2) years post\u2010transplantation, the mean serum haemoglobin level was 13.9\u00a0\u00b1\u00a01.8\u00a0g\/dL in men and 12.8\u00a0\u00b1\u00a01.5\u00a0g\/dL in women. Lower haemoglobin levels were independently associated with a lower CER (std. \u03b2\u00a0=\u00a00.07, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), BIA\u2010derived skeletal muscle mass (std. \u03b2\u00a0=\u00a00.22, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), handgrip strength (std. \u03b2\u00a0=\u00a00.15, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and worse FTSTS test scores (std. \u03b2\u00a0=\u00a0\u22120.17, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). KTRs in the lowest age\u2010specific and sex\u2010specific quartile of haemoglobin levels had an increased risk of being in the worst age\u2010specific and sex\u2010specific quartile of CER (fully adjusted OR, 2.09; 95% CI 1.15\u20133.77; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), handgrip strength (fully adjusted OR, 3.30; 95% CI 1.95\u20135.59; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and FTSTS test score (fully adjusted OR, 7.21; 95% CI 2.59\u201320.05; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low haemoglobin levels are strongly associated with decreased muscle mass and strength in KTRs. Future investigation will need to investigate whether maintaining higher haemoglobin levels may improve muscle mass and strength in KTRs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12999","type":"journal-article","created":{"date-parts":[[2022,6,4]],"date-time":"2022-06-04T06:39:28Z","timestamp":1654324768000},"page":"2044-2053","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients"],"prefix":"10.1002","volume":"13","author":[{"given":"Joanna Sophia J.","family":"Vinke","sequence":"first","affiliation":[{"name":"Department of Nephrology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanneke J.C.M.","family":"Wouters","sequence":"additional","affiliation":[{"name":"Department of Hematology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"},{"name":"Department of Endocrinology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne P.","family":"Stam","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rianne M.","family":"Douwes","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Post","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio W.","family":"Gomes\u2010Neto","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie M.","family":"van der Klauw","sequence":"additional","affiliation":[{"name":"Department of Endocrinology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan P.","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan J.L.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Medical Center 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