Muscle Mass Assessed by Computed Tomography at the Third Lumbar Vertebra Predicts Patient Survival in Chronic Kidney Disease
J. renal nutr
; 31(4): 342-350, July. 2021. graf, tab
Article
in English
| CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1353267
Responsible library:
BR79.1
ABSTRACT
OBJECTIVE:
Muscle mass is a key element for the evaluation of nutritional disturbances in patients with chronic kidney disease (CKD). Low muscle mass is associated with increased morbidity and mortality. The assessment of muscle mass by computed tomography at the third lumbar vertebra region (CTMM-L3) is an accurate method not subject to errors from fluctuation in the hydration status. Therefore, we aimed at investigating whether CTMM-L3 was able to predict mortality in nondialyzed CKD 3-5 patients.METHODS:
This is a prospective observational cohort study. We evaluated 223 nondialyzed CKD patients (60.3 ± 10.6 years; 64% men; 50% diabetics; glomerular filtration rate 20.7 ± 9.6 mLmin1.73 m2). Muscle mass was measured by CTMM-L3 using the Slice-O-Matic software and analyzed according to percentile adjusted by gender. Nutritional parameters, laboratory data, and comorbidities were evaluated, and mortality was followed up for 4 years.RESULTS:
During the study period, 63 patients died, and the main cause of death was cardiovascular disease. Patients who died were older, had lower hemoglobin and albumin, as well as lower muscle markers. CTMM-L3 below the 25th percentile was associated with higher mortality according to the Kaplan-Meier curve (P = .017) and in Cox regression analysis (crude hazard ratio, 1.87 [95% confidence interval, 1.11-3.16]), also when adjusting for potential confounders (hazard ratio 1.83 [95% confidence interval 1.02-3.30]).CONCLUSION:
Low muscle mass measured by computed tomography at the third lumbar vertebra region is an independent predictor of increased mortality in nondialyzed CKD patients.
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Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Chronic Kidney Disease
/
Kidney, Renal Pelvis and Ureter Cancer
Database:
CONASS
/
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Renal Insufficiency, Chronic
/
Glomerular Filtration Rate
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
J. renal nutr
Year:
2021
Document type:
Article
Institution/Affiliation country:
Cardiology Division, Federal University of São Paulo/BR
/
Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology/BR
/
Heart Hospital (HCor)/BR
/
Medical Epidemiology and Biostatistics (MEB)/SE
/
National Institute of Cancer, and Brazilian Society of Oncology Nutrition/BR
/
Nutrition Institute, Rio de Janeiro State University/BR
/
Nutrition Institute, Rio de Janeiro State University, National Institute of Cancer and Brazilian Society of Oncology Nutrition/BR
/
Nutrition Program and Nephrology Division, Federal University of São Paulo/BR
/
Renal Medicine and Baxter Novum, Department of Clinical Science/SE