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Abstract: FR-PO903

Ultrasound Evaluation of Rectus Femoris Muscle Thickness as a Diagnostic Tool for Sarcopenia in Peritoneal Dialysis Patients

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Pimenta, Gonçalo Félix, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
  • Martins, Ana Cristina, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
  • Calça, Rita, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
  • Matias, Patrícia, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
Background

Sarcopenia is a frequent cause of morbidity and mortality among patients with chronic kidney disease (CKD), combining loss of both muscle strength and mass. Handgrip strength is a reliable surrogate for measures of arm and leg strength. Several tools have been developed for muscle mass evaluation, such as bioelectrical impedance analysis (BIA). Ultrasound evaluation has been increasing recently, taking advantage of its feasibility in daily clinical setting. The aim of this study was to evaluate the rectus femoris muscle thickness (RFMT) by ultrasound in peritoneal dialysis (PD) patients and its association with muscle strength and BIA parameters.

Methods

Single-centre cross-sectional study including patients on PD for > 3 months and aged > 18 years. Patients with acute infection, amputated limbs and implantable cardiac devices were excluded. Demographic and clinical data were collected from the electronic records. Parameters evaluated included serum biomarkers, BIA and dialysis adequacy. Muscle strength was measured by handgrip strength using a dynamometer. RFMT was evaluated using ultrasound at bedside.

Results

A total of 32 patients (19 male) were included with a mean age of 59±15 years. PD vintage was 17 months (10,5-29,8) with a weekly Kt/V of 1,98 (1,68-2,55). Most were on continuous ambulatory peritoneal dialysis (CAPD; 68,8%), either as high or medium-high transporters (65,6%). Hypertension was reported in 28 patients (87,5%), accompanied by diabetes mellitus (DM; 31,3%), peripheral artery disease (31,3%) and obesity (28,1%). Age (r=-0,442; p=0,013), Clinical Frailty Score (r=-0,481; p=0,006) and NT-proBNP (r=-0,54; p=0,003) were negatively associated with RFMT. Lean tissue index (r=0,357; p=0,049), phase angle (r=0,567; p=0,001) and handgrip strength (r=0,49; p=0,006) were positively associated with RFMT. In a multivariate analysis, phase angle (adjusted R2=0,261; p=0,026) was positively associated with RFMT, adjusting to age, time on PD, DM and serum albumin.

Conclusion

Ultrasound evaluation of RFMT is feasible in daily practice in the outpatient setting. It may be useful as an additional tool to BIA for diagnosis of sarcopenia, particularly in elderly, fragile and malnourished patients. Further prospective studies are warranted in order to validate this tool for PD patients.