Autori: Sabatino A*, Regolisti G*^, Gandolfini I*, Delsante M*, Fini T*, Peyronel F^, Maggiore U^, Fiaccadori E*^.
Affiliazioni: * Renal Failure Unit, Parma University Medical School, ^Postgraduate School in Nephrology, Parma, Italy
Introduction: Protein-Energy Wasting (PEW) is highly prevalent in patients with end-stage renal disease on chronic hemodialysis (ESRD). The assessment of nutritional status and lean body mass is essential for the identification of patients with PEW. The aim of our study was to assess the correlation between skeletal muscle mass on the level of the third lumbar vertebra (L3) assessed by CT scan with mortality in ESRD.
Methods: In a retrospective observational study, 1260 ESRD patients undergoing chronic hemodialysis treatment were identified between 2008 and 2015 in the Dialysis Centers of Parma. Those with at least one available abdomen CT scan and an HD vintage of at least 6 months. CT images at the level corresponding to the L3 were analyzed using a dedicated software.
Results: We enrolled 183 ESRD patients (Table 1).
Skeletal muscle mass at L3 was 118.5 cm2 (± 30.6). Median follow-up was 65.6 months (range 6.6 – 132.5), with a mortality of 67% (122/183) Patients were divided based on quartiles of muscle mass. Patients in the first quartile had 83% mortality, while mortality of patients in the fourth quartile was 52% (OR = 4.16 95% CI = 1.59 – 10.87; P = 0.003). Kaplan-Meier analysis identified a significantly lower survival in patients in the first quartile of muscle mass compared to those in the fourth quartile (Figure 1).
Conclusions: Low abdominal muscle mass appears to be associated with an increased risk of mortality in chronic hemodialysis patients