Feasibility of computed tomography-based assessment of skeletal muscle mass in hemodialysis patients

Abstract

Background: Sarcopenia is a major health issue especially in patients on maintenance hemodialysis. Low skeletal muscle mass is included in the diagnostic criteria for sarcopenia. The skeletal muscle mass is usually evaluated by modalities such as bioimpedance analysis (BIA) or dual-energy x-ray absorptiometry, however the assessment of skeletal muscle mass using computed tomography (CT) images has not been established. The purpose of the study was to investigate the feasibility of the assessment of skeletal muscle mass using CT image in hemodialysis patient.Methods: Skeletal muscle mass index (SMI) was measured by BIA and psoas muscle index (PMI) was measured by cross-sectional CT image in 131 patients. The relationship between SMI and PMI and the diagnostic ability of PMI for low muscle mass were evaluated. Furthermore, the patients were followed up and long-term survival in patients with low and high PMI were compared.Results: PMI measured at L3 vertebral level was strongly correlated with SMI (r = 0.597, p < 0.001). Age, sex, and SMI were the influencing factor for PMI. Patients with low PMI showed higher incidence rates of mortality during the follow up.Conclusions: PMI assessed by CT image can be an alternative to BIA in patients with hemodialysis.

Usefulness of computed tomography-measured psoas muscle thickness per height for predicting mortality in patients undergoing hemodialysis

“…Kurumisawa et al 21 demonstrated that the CT-measured psoas muscle index, assessed before cardiovascular surgery, is a predictor of long-term survival after cardiac surgery. Similarly, Takata et al 22 reported that the CT-measured psoas muscle index is correlated with the bioelectrical impedance analysis–measured skeletal muscle mass index, where a low psoas muscle index is associated with an increased risk of mortality. Moreover, they suggested that the psoas muscle index assessed using CT can be an alternative to bioelectrical impedance analysis in patients undergoing hemodialysis.…”

“…Only a few studies have examined the association between CT-measured sarcopenia indices and mortality in patients undergoing hemodialysis 20 – 22 . Although the use of PMTH for predicting mortality remains unclear, we hypothesized that low PMTH may be an increased risk of mortality in this population.…”

Association between the psoas muscle index and hospitalization for pneumonia in patients undergoing hemodialysis

“…CT-based evaluation of the psoas muscle cross-sectional area and subsequent calculation of PMI has shown good inter-rater reliability [ 16 , 22 ]. Furthermore, PMI correlated with the skeletal muscle mass in dialysis patients [ 16 , 23 ]. Therefore, annual CT scans performed to detect acquired cystic and malignant kidney disease are useful for HD patients [ 23 , 24 ] and may be utilized for the assessment of trunk muscle mass.…”

Skeletal Muscle Mass Is Associated With Erythropoietin Response in Hemodialysis Patients

“…It is being recognized as a great health issue in the elderly population [12][13]. A growing number of evidences have revealed that sarcopenia is related to cardiovascular disease [14], cognitive function [15], physical performance [16], and mortality [17]. The pathogenesis of sarcopenia involves various conditions such as malnutrition and in ammation.…”