Dual Energy X-ray Absorptiometry and Bioimpedance Analysis are Clinically Useful for Measuring Muscle Mass in Kidney Transplant Recipients With Sarcopenia

Yanishi, Masaaki; Kinoshita, Hidefumi; Tsukaguchi, Hiroyasu; Kimura, Yutaka; Koito, Yuya; Jino, Eri; Watanabe, Masaya; Sugi, Motohiko; Matsuda, Tadashi

doi:10.1016/j.transproceed.2017.12.023

Cited by 20 publications

(23 citation statements)

References 22 publications

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“…However, BIA‐derived muscle mass estimation in KTRs is strongly correlated to CT‐based muscle mass estimation. 45 Another limitation is that the FTSTS test score was performed in a smaller sample size as compared with the other muscle parameters. Most likely, the smaller sample size also explains the larger identified odds ratio for patients with low haemoglobin levels of being in the highest quartile of the FTSTS test score as compared with the odds ratios of being in the worst quartile of the other muscle parameters.…”

Section: Discussionmentioning

confidence: 99%

Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients

Vinke

Wouters

Stam

et al. 2022

J cachexia sarcopenia muscle

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Background Post-transplant 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. Methods We included stable KTRs from the TransplantLines Biobank and Cohort study with a functional graft ≥1 year post-transplantation. Muscle mass was assessed using 24 h 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 (n = 290), with the five-times sit-to-stand (FTSTS) test. We used multivariable linear and logistic regression analyses to investigate the associations of haemoglobin levels with muscle mass and strength. ResultsIn 871 included KTRs [median age 58 (interquartile range (IQR), 48-66)] years; 60% men; eGFR 51 ± 18 mL/min/1.73 m 2 ) who were 3.5 (1.0-10.2) years post-transplantation, the mean serum haemoglobin level was 13.9 ± 1.8 g/dL in men and 12.8 ± 1.5 g/dL in women. Lower haemoglobin levels were independently associated with a lower CER (std. β = 0.07, P = 0.01), BIA-derived skeletal muscle mass (std. β = 0.22, P < 0.001), handgrip strength (std. β = 0.15, P < 0.001), and worse FTSTS test scores (std. β = À0.17, P = 0.02). KTRs in the lowest age-specific and sex-specific quartile of haemoglobin levels had an increased risk of being in the worst age-specific and sex-specific quartile of CER (fully adjusted OR, 2.09; 95% CI 1.15-3.77; P = 0.02), handgrip strength (fully adjusted OR, 3.30; 95% CI 1.95-5.59; P < 0.001), and FTSTS test score (fully adjusted OR, 7.21; 95% CI 2.59-20.05; P < 0.001). Conclusions 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.

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Section: Discussionmentioning

confidence: 99%

Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients

Vinke

Wouters

Stam

et al. 2022

J cachexia sarcopenia muscle

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“…Computed tomography (CT) and magnetic resonance imaging (MRI) are considered the gold standards for assessment of muscle mass, but are not often used for nutritional assessment in clinical practice because of the high costs and practical limitations [38,55]. The GLIM therefore recommends using other indirect body composition measures, such as DEXA or BIA [19], and a previous study in RTR, with mostly a healthy BMI, showed that estimations of muscle mass by CT, DEXA and BIA were well-correlated [56]. However, the use of BIA to estimate muscle mass may include errors caused by changes in hydration status and, importantly, may overestimate muscle mass in obesity [57,58].…”

Section: Discussionmentioning

confidence: 99%

Malnutrition according to GLIM criteria in stable renal transplant recipients: Reduced muscle mass as predominant phenotypic criterion

et al. 2021

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Background & aims: Malnutrition has a negative impact on quality of life and survival in renal transplant recipients (RTR). Therefore, malnutrition detection is important in RTR, but this may be hampered by concomitant presence of weight gain and overweight. Recently, the Global Leadership Initiative on Malnutrition (GLIM) developed a set of diagnostic criteria for malnutrition. We aimed to assess the prevalence of malnutrition according to the GLIM criteria and the distribution of phenotypic criteria in RTR. Additionally, we examined the potential value of 24-h urinary creatinine excretion rate (CER) as alternative measure for the criterion reduced muscle mass. Methods: We used data from stable outpatient RTR included in the TransplantLines Cohort and Biobank Study (NCT02811835). Presence of weight loss and reduced intake or assimilation were derived from Patient-Generated Subjective Global Assessment (PG-SGA) item scores. Reduced muscle mass was assessed by multi-frequency bio-electrical impedance analysis (MF-BIA) and defined as an appendicular skeletal muscle mass index (ASMI) < 7 kg/m 2 for men and <5.5 kg/m 2 for women, and in additional analysis defined as creatinine-height index (CHI, based on 24 h urine CER) < 80%. Inflammation was present if C-reactive protein (CRP) was >5 mg/L. Malnutrition was defined as presence of at least one phenotypic (weight loss and/or low BMI and/or reduced muscle mass) and one etiologic criterion (reduced intake/assimilation and/or disease burden/inflammation). Results: We included 599 RTR (55 ± 13 years old, 62% male, BMI 27.2 ± 4.7 kg/m 2 ) at a median of 3.1 years after transplantation. According to GLIM criteria, 14% was malnourished, of which 91% met the phenotypic criterion for reduced muscle mass. Similar results were found by using CHI as measure for muscle mass (13% malnutrition of which 79% with reduced muscle mass). Conclusions: Malnutrition is present in one in 7 stable RTR, with reduced muscle mass as the predominant phenotypic criterion. Assessment of nutritional status, most importantly muscle status, is warranted in routine care, to prevent malnutrition in RTR from remaining undetected and untreated. The diagnostic value of 24-h urinary CER in this regard requires further investigation.

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“…According to Yanishi et al, the CT scan is the reference test for muscle mass quantification and its correlation with functional parameters (BIA, DXA) is high. 26 Several parameters exist for the evaluation of muscle mass on CT scan, notably SMI, PMI, and transversal psoas thickness index. 27 We chose the SMI because it is the best scanographic parameter for muscle analysis according to the latest recommendations of the EWGSOP2 (European working group on sarcopenia in older people 2).…”

Section: Discussionmentioning

confidence: 99%

Skeletal Muscle Index as a Prognostic Marker for Kidney Transplantation in Older Patients

Deliège

Braconnier

Chaix

et al. 2021

Journal of Renal Nutrition

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Objective: Low skeletal muscle mass has emerged as a risk factor for mortality after liver transplantation. We evaluated the prognostic value of muscle mass on length of hospitalization and adverse outcomes after kidney transplantation in aging end-stage renal disease patients.Methods: One hundred twenty-two patients aged 60 years or older at the time of transplantation were retrospectively analyzed. Skeletal muscle index (SMI), evaluated by computed tomography scan, was calculated from total muscle surface area at L3 vertebral level divided by body height squared. Outcomes were compared according to SMI (namely, length of hospitalization, wound complications, combined endpoint comprising all-cause mortality, and graft failure within 1 year).Results: In male patients, by multivariate analysis, a low SMI (,42 cm 2 /m 2 ) was associated with longer immediate posttransplantation hospitalization (b 5 17.03 6 4.3; P 5 .0002), longer total hospitalization during the first year (b 5 34.3 6 10.7; P 5 .002), higher rate of wound complications (odds ratio 5 12.1 [1.9-77.0]; P 5 .008), and higher rate of the combined endpoint of graft loss or death (odds ratio 5 3.4 [3.0-399.5]; P 5 .004). In female patients, low SMI was not associated with length of hospitalization or adverse outcomes after transplantation.Conclusion: SMI is an independent marker of morbidity and mortality after kidney transplantation in older men and could help thereby nephrologists better select aging candidates for kidney transplantation with a view to improving post-transplant outcomes.

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Dual Energy X-ray Absorptiometry and Bioimpedance Analysis are Clinically Useful for Measuring Muscle Mass in Kidney Transplant Recipients With Sarcopenia

Cited by 20 publications

References 22 publications

Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients

Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients

Malnutrition according to GLIM criteria in stable renal transplant recipients: Reduced muscle mass as predominant phenotypic criterion

Skeletal Muscle Index as a Prognostic Marker for Kidney Transplantation in Older Patients

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