Impact of Sarcopenia on Acute Kidney Injury after Infrarenal Abdominal Aortic Aneurysm Surgery: A Propensity Matching Analysis

Abstract

Background: Sarcopenia contributes to increased morbidity and mortality in patients undergoing surgery for abdominal aortic aneurysms (AAA). However, few reports have demonstrated whether sarcopenia would affect the development of postoperative acute kidney injury (AKI) in these patients. This study aimed to examine whether sarcopenia is associated with AKI and morbidity and mortality after infrarenal AAA operation. Methods: We retrospectively analysed 379 patients who underwent infrarenal AAA surgery. The diagnosis of sarcopenia was performed using the skeletal muscle index, which was calculated from axial computed tomography at the level of L3. The patients were separated into those with sarcopenia (n = 104) and those without sarcopenia (n = 275). We applied multivariable and Cox regression analyses to evaluate the risk factors for AKI and overall mortality. A propensity score matching (PSM) evaluation was done to assess the postoperative results. Results: The incidence of AKI was greater in sarcopenia than non-sarcopenia group before (34.6% vs. 15.3%; p < 0.001) and after the PSM analysis (34.6% vs. 15.4%; p = 0.002). Multivariable analysis revealed sarcopenia to be associated with AKI before (p = 0.010) and after PSM (p = 0.016). Sarcopenia was also associated with overall mortality before (p = 0.048) and after PSM (p = 0.032). A Kaplan–Meier analysis revealed that overall mortality was elevated patients with sarcopenia before and after PSM than in those without (log-rank test, p < 0.001, p = 0.022). Conclusions: Sarcopenia was associated with increased postoperative AKI incidence and overall mortality among individuals who underwent infrarenal AAA operation.

Effect of low skeletal muscle mass on long-term mortality after abdominal aortic aneurysm repair: A meta-analysis

“…Eight articles were excluded and the remaining fifteen studies were found to be eligible for this meta-analysis. [13][14][15][16][18][19][20][23][24][25][26][27][28][29][30] The majority of the studies were retrospective cohort in nature ( There was wide variation in the studies in defining low skeletal muscle mass. All studies measured defined skeletal muscle area by measuring the bilateral psoas muscles with or without additional muscular structures.…”

Association of skeletal muscle index with postoperative acute kidney injury in living donor hepatectomy: A retrospective single‐centre cohort study

“…It has also been reported that sarcopenia is associated with kidney damage and decreased estimated glomerular filtration rate 21,22 . Another study demonstrated that sarcopenia is associated with increased postoperative AKI incidence in infrarenal abdominal aortic aneurysms operation 23 …”

“…21,22 Another study demonstrated that sarcopenia is associated with increased postoperative AKI incidence in infrarenal abdominal aortic aneurysms operation. 23 However, there are no studies on the association between donor sarcopenia and postoperative surgical outcomes in donors undergoing hepatectomy for LT. Therefore, in this study, we evaluated the association between donor sarcopenia and the development of postoperative AKI after donor hepatectomy.…”

Kidney Function, Male Gender, and Aneurysm Diameter Are Predictors of Acute Kidney Injury in Patients with Abdominal Aortic Aneurysms Treated Endovascularly

“…Additionally, sarcopenia—musculoskeletal loss was associated with AKI occurrence after AAA repair—is known to be an independent mortality factor following AAA therapy. According to studies [ 9 , 10 ] PC-AKI is the third most common reason for hospital-acquired acute renal failure and is linked to a high mortality rate. Due to this, a number of methods (such as pre and posthydration and the injection of N-acetylcysteine) have been shown to be somewhat useful in preventing CIN [ 11 ], but they are not always practical, particularly when treating patients who have suffered serious injuries.…”