<b><i>Introduction:</i></b> Computed tomography (CT) can accurately measure muscle mass, which is necessary for diagnosing sarcopenia, even in dialysis patients. However, CT-based screening for such patients is challenging, especially considering the availability of equipment within dialysis facilities. We therefore aimed to develop a bedside prediction model for low muscle mass, defined by the psoas muscle mass index (PMI) from CT measurement. <b><i>Methods:</i></b> Hemodialysis patients (<i>n</i> = 619) who had undergone abdominal CT screening were divided into the development (<i>n</i> = 441) and validation (<i>n</i> = 178) groups. PMI was manually measured using abdominal CT images to diagnose low muscle mass by two independent investigators. The development group’s data were used to create a logistic regression model using 42 items extracted from clinical information as predictive variables; variables were selected using the stepwise method. External validity was examined using the validation group’s data, and the area under the curve (AUC), sensitivity, and specificity were calculated. <b><i>Results:</i></b> Of all subjects, 226 (37%) were diagnosed with low muscle mass using PMI. A predictive model for low muscle mass was calculated using ten variables: each grip strength, sex, height, dry weight, primary cause of end-stage renal disease, diastolic blood pressure at start of session, pre-dialysis potassium and albumin level, and dialysis water removal in a session. The development group’s adjusted AUC, sensitivity, and specificity were 0.81, 60%, and 87%, respectively. The validation group’s adjusted AUC, sensitivity, and specificity were 0.73, 64%, and 82%, respectively. <b><i>Discussion/Conclusion:</i></b> Our results facilitate skeletal muscle screening in hemodialysis patients, assisting in sarcopenia prophylaxis and intervention decisions.
General HospitalKeywords: exercise during dialysis therapy, frail, sarcopenia, QOL, KDQOL SF 〈Abstract〉 Twenty hemodialysis patients underwent 6 monthsʼ exercise therapy. Physical motor function and nutritional assessments were performed before and 3 to 6 months after the start of the intervention. The Holmʼs multiple comparison procedure was used for the statistical analyses. The patientsʼ quality of life (QOL) was evaluated before and after the intervention and compared using the Wilcoxon signed rank test, with p values of <0.05 considered significant. Physical motor function was assessed based on grip strength (non shunt limb), knee extension muscle strength, toe grip strength, and abduction muscle strength at 3 months after the intervention. The subjects exhibited improvements in muscle strength and the results of the 30 second chair stand test and 6 minute walking test after 3 months, which were maintained after 6 months. No significant changes in nutritional parameters, including the blood hemoglobin concentration, were observed. The QOL evaluation revealed that physical function, mental health, the subjectsʼ overall view of their health, and vitality increased. It is pre-
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