Ultrasound quadriceps muscle thickness is variably associated with frailty in haemodialysis recipients

Abstract

Background Ultrasonographic quantitation of quadriceps muscle mass is increasingly used for assessment of sarcopenia, but its relationship with frailty in haemodialysis recipients is not known. This study explores the relationship between ultrasound-derived bilateral anterior thigh thickness (BATT), sarcopenia, and frailty by common frailty tools (Frailty Phenotype [FP], Frailty Index [FI], Edmonton Frailty [EFS], and Clinical Frailty Scale [CFS]). Methods This was an exploratory analysis of a subgroup of adult prevalent (≥3 months) haemodialysis recipients deeply phenotyped for frailty. Ultrasound assessment of BATT was obtained with participants at an angle of ≤45°, with legs outstretched and knees resting at 10°-20°, according to an established protocol. Associations with frailty were explored via both linear and logistic regressions for BATT, Low Muscle Mass (LMM), and sarcopenia with stepwise adjustment for a priori covariables. Results In total 223 study participants had ultrasound measurements. Frailty ranged from 34% for FP to 58% for FI. BATT was associated with increasing frailty on simple linear regression by all frailty tools, but lost significance on addition of covariables. Upon dichotomising frailty tools into Frail/Not Frail, BATT was associated with frailty by all tools on univariable analyses, but only retained association for EFS on the fully adjusted model (OR 0.97, 95% C.I. 0.94–1.00, P = 0.05). Conclusions Ultrasound measures of quadriceps thickness is variably associated with frailty in prevalent haemodialysis recipients, dependent upon the frailty tool used, but not independent of other variables. Further work is required to establish the added value of sarcopenia measurement in frail haemodialysis patients. Trial registration Clinicaltrials.gov: NCT03071107 registered 06/03/2017.

Concordance between muscle mass assessed by bioelectrical impedance analysis and by muscle ultrasound: a cross-sectional study in a cohort of patients on chronic hemodialysis

“…Also, our reported prevalence is slightly higher than that stated by Fu et al [ 30 ] who found that 51.3% of HD patients had confirmed sarcopenia. Furthermore, Anderson et al found a lower percentage of HD patients, compared to the current results, to have sarcopenia [ 31 ]. A recent systematic review and meta-analysis, which included 30 studies, reported a wide variation in the prevalence of sarcopenia from 4 to 68% among patients on dialysis [ 32 ].…”

Uncovering sarcopenia and frailty in older adults by using muscle ultrasound—A narrative review

“…Another study was conducted in 223 haemodialysis patients to study the association between ultrasound-derived bilateral anterior thigh thickness (BATT), sarcopenia, and frailty by utilizing common frailty tools such as the Frailty Phenotype, Frailty Index, Edmonton Frailty, and Clinical Frailty Scale (110). Ultrasound measurements of quadriceps muscle thickness were found to be variably associated with frailty depending on the frailty tool used (110).…”

Frailty and the Interactions between Skeletal Muscle, Bone, and Adipose Tissue-Impact on Cardiovascular Disease and Possible Therapeutic Measures

“…Regarding the available tools for the identification and assessment of frailty, there is still no standard instrument to identify it; however, sarcopenia and frailty can be measured by imaging techniques and the use of ultrasound has been proposed to evaluate muscle, in order to support diagnosis and follow-up [25].The application of muscle ultrasounds in sarcopenia and frailty is already under study in very specific conditions [26] (Figure 2). disorders [13].…”