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Abstract: SA-PO569

Assessing Muscle Mass and Radiodensity via Chest CT for Prognostic Insights in Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Liu, Jianqiang, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, Guangdong, China
  • Ye, Zengchun, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, Guangdong, China
  • Peng, Hui, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, Guangdong, China
Background

CKD often leads to PEW, which in turn contributes to the development of sarcopenia. This condition is strongly associated with increased mortality. Consequently, evaluating muscle mass in HD patients is of significant clinical relevance. However, the relationship between muscle mass measured by Chest CT and prognosis for HD patients remains unclear.

Methods

Between January 2015 and December 2019, we conducted a retrospective study involving HD patients in a hemodialysis center. Chest CT scans at T12 level were analyzed using segmentation software to assess SMI and SMD.

Results

A total of 303 patients were included, with a mean age of 55.4± 16.6 years and a median follow-up period of 4.6 years. During the follow-up period, 78 deaths occurred. Sex-specific cut-offs of SMI and SMD were determined using maximally selected rank statistics analysis: 96 patients(31.6%)with SMI <30(male) or <24.35(female) cm2/m2 and 99 patients(32.6%)with SMD <38.61 (male) or <31.44(female) HU were categorized as having lower SMI and lower SMD, respectively. Patients with lower SMI and lower SMD consistently demonstrated an increased risk of any cause deaths, as evidenced by Kaplan Meier survival curves. After adjusting for confounding factors using mult ivariate Cox proportional risk models, lower SMI and lower SMD were independently associated with a higher risk of all-cause mortality and non-cardiovascular mortality. This association persisted in subgroup analyses and competitive risk model. Adding SMI and SMD to the established risk model improved the C-index from 0.78 to 0.82 (P < 0.001), with similar results observed in NRI and IDI. Decision curve analysis revealed that the prognostic model incorporating both SMI and SMD yielded the highest net benefit for predicting all-cause mortality.

Conclusion

SMI and SMD measurements derived from chest CT-T12 images provide valuable prognostic information, potentially enhancing the criteria for chest CT use in sarcopenia studies among HD patients.

Kaplan-Meier analysis of any cause mortality.