Kidney Week

Abstract: FR-PO089

The Association Between Skeletal Muscle Mass and Survival/Renal Recovery from Dialysis in Patients with Sepsis-Associated AKI Receiving Continuous Renal Replacement Therapy

Session Information

• AKI: Epidemiology, Risk Factors, Prevention - I
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Kim, Do Kyun, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Do Kyun Kim,

• Jang, Kyu Won, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Kyu Won Jang,

• Koo, Bon Jin, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Bon Jin Koo,

• Ye, Byung Min, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Byung Min Ye,

• Kim, Seo Rin, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Seo Rin Kim,

• Kim, Il Young, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Il Young Kim,

• Lee, Dong Won, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Dong Won Lee,

• Lee, Soo Bong, Pusan National University Yangsan Hospital Nephrology Clinic, Yangsan, Korea (the Republic of)

Soo Bong Lee,

Background

Lower skeletal muscle mass at intensive care unit (ICU) admission has been associated with poor outcomes. In this study, we investigate the independent association between computed tomography (CT)-measured skeletal muscle mass and survival, as well as renal recovery from dialysis, in patients with sepsis-induced acute kidney injury (SIAKI) who are undergoing continuous renal replacement therapy (CRRT).

Methods

In this retrospective study, a total of 618 patients with SIAKI who CRRT in our ICU were included. Within three days prior to ICU admission, all patients underwent abdominal CT scans. The cross-sectional area of skeletal muscle at the 3rd lumbar vertebra was measured, and the skeletal muscle index (SMI), a normalized measure of skeletal muscle mass, was calculated. Patients were categorized into sarcopenia and non-sarcopenia groups using Korean-specific cutoffs of SMI.

Results

Out of the 618 patients included in the study, 301 expired within 28 days of ICU admission. Non-survivors exhibited a higher prevalence of sarcopenia and SMI compared to survivors. The results of multivariable Cox regression analysis revealed that sarcopenia independently predicted 28-day mortality (hazard ratio [HR]: 2.66; 95% confidence interval [CI]: 1.42–2.38; P < 0.001). Among the survivors, sarcopenia was independently associated with a lower likelihood of renal recovery from dialysis within 28 days of ICU admission (HR: 0.42, 95% CI: 0.26–0.68; P < 0.001). Kaplan-Meier analysis demonstrated that sarcopenic patients had lower rates of survival and renal recovery from dialysis within 28 days of ICU admission compared to non-sarcopenic patients.

Conclusion

This study demonstrated that sarcopenia assessed by CT-derived skeletal muscle mass was independently associated with both survival and renal recovery from dialysis in patients with SIAKI receiving CRRT. These findings highlight the potential value of sarcopenia as a prognostic tool in this patient population.