Muscle Density Predicts Death Risk in Patients Waiting for a Kidney

Each Hounsfield unit increase on CT is associated with a 7% decreased risk of death among waitlisted kidney transplant candidates.
Each Hounsfield unit increase on CT is associated with a 7% decreased risk of death among waitlisted kidney transplant candidates.

Greater muscle density is independently associated with lower mortality among waitlisted kidney transplant candidates, researchers reported at the 2016 American Transplant Congress in Boston.

Jayme E. Locke, MD, MPH, of the University of Alabama at Birmingham (UAB), and colleagues studied 80 kidney transplant candidates waitlisted from 2008 to 2009 and who had computed tomography (CT) imaging available at the time of listing. Investigators followed up patients to the earliest of transplant, death, or administrative end of the study. After a median of 3.8 years of follow-up, 31 patients died while waiting for a transplant, 23 received transplants, and 26 were still awaiting transplants. Morphometric measures assessed on CT included abdominal adipose tissue, paraspinous and psoas muscle composition, and aortic calcification.

After controlling for multiple factors, only higher psoas muscle attenuation—which indicates leaner muscle mass—remained significantly associated with waitlist mortality, with each Hounsfield unit increase in attenuation associated with a 7% decreased risk of death.

“Our results suggest that radiologic measures of sarcopenia, such as lean muscle mass versus adiposity, improve mortality risk prediction among waitlisted ESRD [end-stage renal disease] patients,” said Dr Locke, Assistant Professor of Surgery and Director of Transplant Analytics, Informatics & Quality at UAB. “These findings are novel and clinically useful as they may help inform decision-making with regard to candidate selection.”

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