Muscle mass assessment by computed tomography in chronic kidney disease patients: agreement with surrogate methods

Abstract

The MAMC and Baumgartner equation showed the best agreement with CT for the assessment of muscle mass in non-dialysis CKD patients.

Comparative Analysis Between Computed Tomography and Surrogate Methods to Detect Low Muscle Mass Among Colorectal Cancer Patients

“…In agreement with our results, Raeder et al, in a study with 97 nonmetastatic CRC patients, identified 64% sensitivity and 78% specificity of the physical examination from PG‐SGA when compared with fat‐free mass estimated by BIA . On the other hand, in a study from our group carried out in nondialyzed chronic kidney disease patients, we failed to show good agreement between CT and the physical examination (κ coefficient in males: 0.32; sensitivity: 40%; specificity: 88%; κ coefficient in female: −0.12; sensitivity: 9%; specificity: 79%) . The difference in the results between oncologic and chronic kidney disease patients may be attributed to the characteristics related to the group itself.…”

“…In parallel, computed tomography (CT) is considered a gold‐standard method for evaluating body composition . Recently, the level of the third lumbar vertebra (L3) from CT scan has been validated as the standard landmark to assess body composition in patients with cancer and has been used to assess muscle mass in some studies in oncological and non‐oncological individuals . Although the CT scan of the abdomen includes the scan of the L3 and is routinely used for diagnosis and follow‐up in colorectal cancer (CRC) patients, its high cost, the need for training, and the exposure to radiation dose limit the use of CT to research purposes.…”

Sarcopenia in chronic kidney disease: what have we learned so far?

“…The consequences of muscle loss are not only related to physical disability as commonly observed in the elderly. In fact, many studies in the past decades have also linked muscle loss in CKD patients with worse QoL, depression, PEW, fracture risk, cardiovascular complications, graft failure and postoperative complications in transplant recipients, as well as with increased hospitalization and mortality [23][24][25][26][27][28][29][30]. The etiologic factors of muscle derangements leading to muscle loss in CKD are diverse and can be related to several conditions including the kidney disease itself, the dialysis procedure and the typical chronic low-grade inflammation present in CKD patients that together increase protein degradation, decrease protein synthesis and lead to a negative protein balance [31,32] (Fig.…”

“…Therefore, currently used cutoffs to clinically identify sarcopenia in the general population might not be appropriate for CKD including dialysis patients. The definition of what constitutes a low nutritional 2 kg for women) showed the best agreement in terms of sensitivity, specificity and area under the curve with muscle mass assessed by CT, using the value below the 25th percentile to define low muscle mass (for men 139.1 cm 2 and for women 97.5 cm 2 ) [30]. In a subsequent study with the same cohort, the use of muscle mass assessed by CT at the 3rd lumbar vertebra with the cutoff value below the 25th percentile to define low muscle mass (< 138 cm 2 for men and < 98 cm 2 for women) was associated with higher all-cause mortality [76].…”

“…The consequences of muscle loss are not only related to physical disability as commonly observed in the elderly. In fact, many studies in the past decades have also linked muscle loss in CKD patients with worse QoL, depression, PEW, fracture risk, cardiovascular complications, graft failure and post-operative complications in transplant recipients, as well as with increased hospitalization and mortality [ 23 – 30 ].…”