Sarcopenia is associated with survival in patients awaiting kidney transplant

IF 3.2 2区医学 Q1 SURGERY

Surgery Pub Date : 2024-09-20 DOI:10.1016/j.surg.2024.08.028

Julia Wendland BS , Abhinav Seth MD , Patrick Ten Eyck PhD , Jude Longo MD , Grace Binns LPN , M. Lee Sanders PhD, MD , Jodell L. Hornickel MS, ARNP , Melissa Swee MD , Roberto Kalil MD , Daniel A. Katz MD

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引用次数: 0

Abstract

Background

The relationship of sarcopenia to frailty and other survival determinants in patients waitlisted for kidney transplant is not well characterized. Our goal was to evaluate the relationship of muscle area to functional and frailty metrics and its impact on survival in patients waitlisted for kidney transplant.

Methods

Among 303 consecutively listed transplant candidates, 172 had a computed scan within 3 months of frailty and biochemical testing that permitted muscle area evaluation. Third lumbar level psoas muscle indices (total bilateral psoas area/height²) were calculated. Testing included frailty metrics, treadmill and pedometer ability, troponin, and brain natriuretic peptide levels. Associations between muscle area, demographic, biochemical, and frailty measures were analyzed. Log-rank test was used to evaluate waitlist survival on the basis of muscle area, and multivariate Cox proportional hazards modeling was used to evaluate factors independently associated with survival.

Results

Demographic factors associated with third lumbar level psoas muscle indices include male sex (P < .001), race (P = .02), age (P = .004), and body mass index (P < .0001). Grip strength, treadmill ability, and Sit-Stands positively correlated with third lumbar level psoas muscle indices (P < .01). Brain natriuretic peptide and Up and Go negatively correlated with third lumbar level psoas muscle indices (P < .01). Survival was significantly associated with third lumbar level psoas muscle indices (P = 0.02). Treadmill ability, Sit-Stands, Up and Go, race and muscle area were most closely associated with waitlist survival on multivariate modeling.

Conclusion

Sarcopenia as assessed with muscle area measurements is independently associated with kidney waitlist survival. Functional ability and muscle area may be overlapping, but noncongruent, determinants of waitlist outcomes and may need to be individually assessed to create the most predictive survival model.

查看原文本刊更多论文

肌肉疏松症与等待肾移植患者的存活率有关。

背景：在等待肾移植的患者中，肌肉疏松症与虚弱及其他生存决定因素之间的关系尚未得到很好的描述。我们的目标是评估肌肉面积与功能和虚弱指标的关系及其对肾移植候选患者生存的影响：在 303 名连续列名的移植候选者中，有 172 人在体弱和生化检测后 3 个月内进行了计算机扫描，从而对肌肉面积进行了评估。计算第三腰椎水平腰肌指数（双侧腰肌总面积/身高2）。测试包括虚弱指标、跑步机和计步器能力、肌钙蛋白和脑钠肽水平。分析了肌肉面积、人口统计学指标、生化指标和虚弱指标之间的关联。使用对数秩检验评估基于肌肉面积的候补名单存活率，使用多变量考克斯比例危险模型评估与存活率独立相关的因素：结果：与第三腰椎水平腰肌指数相关的人口统计学因素包括男性（P < .001）、种族（P = .02）、年龄（P = .004）和体重指数（P < .0001）。握力、跑步机能力和坐立与第三腰椎水平腰肌指数呈正相关（P < .01）。脑钠肽和 "起来走 "与第三腰椎水平腰肌指数呈负相关（P < .01）。存活率与第三腰椎水平腰肌指数明显相关（P = 0.02）。在多变量模型中，跑步机能力、坐立、起立和走动、种族和肌肉面积与候选者生存率的关系最为密切：结论：通过肌肉面积测量评估的 "肌肉疏松症 "与肾脏候选者存活率密切相关。功能能力和肌肉面积可能是候选结果的重叠但不一致的决定因素，可能需要进行单独评估，以建立最具预测性的生存模型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery 医学-外科

CiteScore

5.40

自引率

5.30%

发文量

687

审稿时长

64 days

期刊介绍： For 66 years, Surgery has published practical, authoritative information about procedures, clinical advances, and major trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons.