Abstract: FR-PO0401
Association Between Subcutaneous Fat Computed Tomography Attenuation and Mortality in Patients Undergoing Hemodialysis
Session Information
- Dialysis: Measuring and Managing Symptoms and Syndromes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Ishikawa, Ryosuke, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Nakamura, Yoshihiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Okazaki, Masaki, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Kurasawa, Shimon, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Nishibori, Nobuhiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Imaizumi, Takahiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Kojima, Mitsuharu, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Yamada, Tetsuya, Nagoya Kyoritsu Byoin, Nagoya, Aichi Prefecture, Japan
- Maruyama, Shoichi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
Background
High computed tomography (CT) attenuation of fat, which may reflect browning or fibrosis, has been associated with higher risk of mortality in patients with cancer. Although CT-based fat quality assessment is feasible, its prognostic significance in patients undergoing hemodialysis (HD) remains unclear. Thus, we evaluated this association in the present study.
Methods
We conducted a cohort study of patients who initiated HD from January 2008 to January 2018. CT images were analyzed using Ziostation2 (Ziosoft Inc.) to measure the area and mean Hounsfield units (HU) of subcutaneous and visceral fat at the L3 vertebral level. The exposures of interest were subcutaneous and visceral fat HU values. The primary outcome was all-cause mortality over a maximum follow-up of 5 years. Subgroup analyses were performed across clinically relevant subgroups.
Results
A total of 444 patients (mean age: 68 years; 70.0% male) were included. Patients in the highest tertile of subcutaneous fat HU had significantly higher risk of mortality than those in the lowest tertile (Figure A). This association remained significant in multivariable Cox regression (HR 2.33, 95% CI: 1.19–4.55). In contrast, visceral fat HU was not significantly associated with mortality (HR 1.18, 95% CI: 0.59–2.36). Although the association between subcutaneous fat HU and mortality was mostly consistent across subgroups, only the age category had a significant interaction. The association was particularly pronounced in patients aged 75 years and older. (Figure B).
Conclusion
Higher subcutaneous fat CT attenuation was associated with an increased risk of all-cause mortality in patients undergoing HD. CT-based assessment of subcutaneous fat quality may be particularly useful in older patients on HD.