Abstract: FR-PO0059
Sex-Specific Association Between Psoas Muscle Index and Kidney Outcomes in Patients with ADPKD
Session Information
- ADPKD and Cystic Kidney Disease - 2
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1201 Genetic Diseases of the Kidneys: Cystic (Monogenic)
Authors
- Ushio, Yusuke, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- Nakai, Anna, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- Takahashi, Rina, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- Manabe, Shun, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- Kataoka, Hiroshi, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- Tsuchiya, Ken, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- Nitta, Kosaku, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- Hoshino, Junichi, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
Background
Loss of skeletal muscle mass is associated with adverse outcomes in chronic kidney disease; however, its significance in autosomal dominant polycystic kidney disease (ADPKD) remains unclear. We investigated the association between psoas muscle index (PMI) and renal outcomes in patients with ADPKD, focusing on sex differences.
Methods
We retrospectively analyzed patients with ADPKD who underwent baseline computed tomography. PMI was calculated as psoas muscle area indexed to height squared. The primary outcome was a composite of a ≥30% decline in eGFR or initiation of renal replacement therapy. Kaplan–Meier and Cox proportional hazards analyses were performed separately by sex. PMI was categorized into sex-specific tertiles. Multivariable models were adjusted for age, baseline eGFR, height-adjusted total kidney volume (htTKV), and tolvaptan use.
Results
A total of 397 patients with ADPKD (182 men and 215 women) were included. PMI was significantly higher in men than in women (9.08 vs. 5.95 cm^2/m^2, p＜0.0001).
In men, Kaplan–Meier analysis showed significant differences in renal survival among PMI tertiles (log-rank p=0.0005), with the low PMI group showing the poorest renal prognosis. Median renal survival times were 2.72, 5.98, and 5.09 years in the low-, moderate-, and high-PMI groups, respectively. In multivariable Cox analysis, low PMI remained independently associated with a higher risk of renal events after adjustment for age and baseline eGFR (overall effect p=0.0087), and the association persisted after further adjustment for htTKV and tolvaptan use (p=0.022). Compared with the moderate PMI group, the low PMI group had a hazard ratio (HR) of 1.70 (95% confidence interval [CI], 0.99–2.93), whereas the moderate PMI group had a lower risk than the high PMI group (HR 0.48, 95% CI 0.28–0.85).
In women, Kaplan–Meier analysis also showed significant differences among PMI tertiles (log-rank p=0.0003); however, the association was attenuated after multivariable adjustment.
Conclusion
Low PMI was independently associated with adverse renal outcomes in male patients with ADPKD, even after adjustment for renal function, kidney volume, and tolvaptan use. In contrast, this association was not independent in women, suggesting a sex-specific relationship between skeletal muscle mass and renal disease progression in ADPKD.