Low skeletal muscle mass is associated with mortality in kidney transplant recipients

Kim, Hyun Jeong; Hong, Namki; Kim, Hyung Woo; Yang, Jaeseok; Kim, Beom Seok; Huh, Kyu Ha; Kim, Myoung Soo; Lee, Juhan

doi:10.1016/j.ajt.2022.11.016

Cited by 6 publications

(4 citation statements)

References 34 publications

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“…Low muscle mass has emerged as a strong predictor of mortality in various populations. Several investigators, including our group, have reported an association between low muscle mass and poor transplant outcomes after KT 29 , 30 .…”

Section: Discussionmentioning

confidence: 77%

Creatinine-cystatin C ratio and death with a functioning graft in kidney transplant recipients

Choi,

Kim,

Yim

et al. 2024

Sci Rep

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Death with a functioning graft is important cause of graft loss after kidney transplantation. However, little is known about factors predicting death with a functioning graft among kidney transplant recipients. In this study, we evaluated the association between post-transplant creatinine-cystatin C ratio and death with a functioning graft in 1592 kidney transplant recipients. We divided the patients into tertiles based on sex-specific creatinine-cystatin C ratio. Among the 1592 recipients, 39.5% were female, and 86.1% underwent living-donor kidney transplantation. The cut-off value for the lowest creatinine-cystatin C ratio tertile was 0.86 in males and 0.73 in females. The lowest tertile had a significantly lower 5-year patient survival rate and was independently associated with death with a functioning graft (adjusted hazard ratio 2.574, 95% confidence interval 1.339–4.950, P < 0.001). Infection was the most common cause of death in the lowest tertile group, accounting for 62% of deaths. A low creatinine-cystatin C ratio was significantly associated with an increased risk of death with a functioning graft after kidney transplantation.

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Section: Discussionmentioning

confidence: 77%

Creatinine-cystatin C ratio and death with a functioning graft in kidney transplant recipients

Choi,

Kim,

Yim

et al. 2024

Sci Rep

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“…A low skeletal muscle mass before kidney transplantation is reportedly associated with an increased likelihood of mortality and hospital readmission after kidney transplantation. [ 29 ] Notably, a low muscle mass was highly correlated with cardiovascular diseases in previous studies. Participants with a low skeletal muscle mass were at greater risk of experiencing cardiovascular events (acute myocardial infarction, unstable angina pectoris, hospitalization for heart failure, coronary revascularization, ischemic stroke, and cardiovascular death).…”

Section: Discussionmentioning

confidence: 93%

“…As with sarcopenia, low muscle mass is known to be closely associated with fractures, quality of life, and cardiovascular diseases. [27][28][29][30][31] In one study, a low skeletal muscle mass was a significant predictor of distal radius fractures. [27] A meta-analysis revealed an association between low skeletal muscle mass and reduced health-related quality of life in patients with cancer, [28] although the interpretation of that correlation is hindered by the diverse classification of low muscle mass among studies.…”

Section: Discussionmentioning

confidence: 99%

Association between pulse pressure and low muscle mass in Korean adults: A nationwide cross-sectional study

Kwon,

Cho,

Park

et al. 2023

Medicine

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Sarcopenia is characterized by a loss of muscle mass and strength and is associated with a high risk of cardiovascular events and increased mortality. Pulse pressure (PP) serves as a marker for changes in heart structure and function, as well as arterial stiffness. A high PP also increases the risk of cardiovascular disease and all-cause mortality. However, the relationship between PP and sarcopenia is poorly understood. We used the data of participants of the Korea National Health and Nutrition Examination Survey (KNHANES) of 2008 to 2011. Participants were divided into a control group (PP < 40 mm Hg) and a high-PP group (PP ≥ 40 mm Hg). PP was calculated by subtracting the diastolic blood pressure (DBP) from the systolic blood pressure (SBP), and the low muscle index was assessed using appendicular skeletal muscle mass (ASM) normalized by body mass index (BMI). Multiple logistic regression analyses were performed to examine the association between PP and the prevalence of low muscle mass, adjusting for potential confounders. The high-PP group had a higher age, SBP, DBP, and prevalence of hypertension, diabetes and hyperlipidemia than the control group. The high-PP group had a higher prevalence of low muscle mass than the control group in all models. A high PP is significantly associated with a higher prevalence of low muscle mass. Therefore, PP monitoring may help identify individuals at risk of sarcopenia and guide interventions to improve health outcomes.

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“…It is defined as calculated skeletal muscle mass more than two standard deviations below the expected muscle mass for normal healthy individuals [ 15 ]. Preexisting low skeletal muscle mass has been clearly linked to poorer outcomes in kidney transplant recipients in terms of increased hospital readmission posttransplant and mortality [ 16 ]. However, the effect of low muscle mass has not been assessed in the recovery of renal function in living kidney donors to date [ 3 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Lean body mass in living kidney donors impacts postoperative renal function

Keenan,

Nic an Riogh,

Brennan

et al. 2024

World J Urol

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Purpose A living donor kidney transplant is the optimal treatment for chronic renal impairment. Our objective is to assess if lean skeletal muscle mass and donor factors such as body mass index, hypertension, and age impact on renal function following donor nephrectomy. Methods Potential donors undergo CT angiography as part of their work-up in our institution. Using dedicated software (Horos®), standardized skeletal muscle area measured at the L3 vertebrae was calculated. When corrected for height, skeletal muscle index can be derived. Skeletal muscle mass index below predefined levels was classified as sarcopenic. The correlation of CT-derived skeletal muscle index and postoperative renal function at 12 months was assessed. Co-variables including donor gender, age, body mass index (BMI), and presence of pre-op hypertension were also assessed for their impact on postoperative renal function. Results 275 patients who underwent living donor nephrectomy over 10 years were included. Baseline pre-donation glomerular filtration rate (GFR) and renal function at one year post-op were similar between genders. 29% (n = 82) of patients met the criteria for CT-derived sarcopenia. Sarcopenic patients were more likely to have a higher GFR at one year post-op (69.3 vs 63.9 mL/min/1.73 m2, p < 0.001). The main factors impacting better renal function at one year were the presence of sarcopenia and younger age at donation. Conclusion When selecting donors, this study highlights that patients with low skeletal mass are unlikely to underperform in terms of recovery of their renal function postoperatively at one year when compared to patients with normal muscle mass and should not be a barrier to kidney donation.

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Low skeletal muscle mass is associated with mortality in kidney transplant recipients

Cited by 6 publications

References 34 publications

Creatinine-cystatin C ratio and death with a functioning graft in kidney transplant recipients

Creatinine-cystatin C ratio and death with a functioning graft in kidney transplant recipients

Association between pulse pressure and low muscle mass in Korean adults: A nationwide cross-sectional study

Lean body mass in living kidney donors impacts postoperative renal function

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