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Abstract: FR-PO086

The Effects of Muscle Mass and Quality on Mortality of Patients With AKI Requiring Continuous Renal Replacement Therapy

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Jung, Jiyun, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)
  • Lee, Jangwook, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)
  • Shin, Sung Joon, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)
  • Kim, Hyosang, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
  • Park, Jae Yoon, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)
Background

Sarcopenia which can lead to decline in physical ability has been known as risk factor on mortality and morbidity. However, little studies have found the effects of muscle mass on mortality of patients with Acute Kidney Injury (AKI) requiring Continuous Renal Replacement Therapy (CRRT).

Methods

We collected 2,221 AKI patients who received CRRT in 8 medical centers between 2006 and 2021. The skeletal muscle areas (SMA) with a threshold of −29 to 150 Hounsfield units from CT images at the level of the 3rd lumbar vertebra was obtained through automated software at ASAN medical center. SMA was further categorized in normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA) to assess the density of muscle. We used Cox proportional hazard model to investigate the association between mortality within 1, 3, and 30 days and skeletal muscle index (SMA, NAMA, and LAMA). In addition, stratified analyses were conducted by sex, age, the acute physiology and chronic health evaluation (APACHE II) score, and the sequential organ failure assessment (SOFA) score to assess the susceptible subgroups.

Results

More than half of the patients (60%) were male and the mean age of patient was 66.01 years. The 30-day mortality rate was 52% (n=1,155). An IQR increase of SMA (38.2cm2) was associated with decreased mortality risk (Hazard ratio [HR]: 0.79, 95% confidence interval [CI]: 0.65–0.97). In subgroup analyses on muscle quality, we identified the 26% decreased risk of LAMA on mortality (HR: 0.74, 95% CI 0.63–0.87) while non-significant effects were found in NAMA (HR:1.05, 95% CI: 0.85–1.29). Stronger protective effects of muscle mass index on mortality were found in male, those who aged over 65 years, and high score group of APACHE II.

Conclusion

We found the protective effects of muscle mass on mortality of AKI patients requiring CRRT. In addition, even if the density was low, the effect of muscle mass itself was significant determinant factors on lowering mortality.

Funding

  • Government Support – Non-U.S.