Abstract: TH-PO100
Sarcopenia May Be a Protective Factor for Mortality in Severe AKI Patients Requiring Continuous Renal Replacement Therapy
Session Information
- AKI: Biomarkers, Drugs, Onco-Nephrology
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- An, Jung Nam, Seoul National University Boramae Medical Center, Seoul, seoul, Korea (the Republic of)
- Oh, Hyung Jung, Ewah Womans' University, Mokdong Hospital, Seoul, Korea (the Republic of)
- Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, seoul, Korea (the Republic of)
- Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
- Ryu, Dong-Ryeol, Ewha Womans University, Seoul, Korea (the Republic of)
- Kim, Sejoong, Seoul National University Bundang Hospital, Seongnam, GyeonGgi-Do, Korea (the Republic of)
Background
Sarcopenia can be defined as degenerative loss of skeletal muscle, which has been associated with poor prognosis in patients with chronic kidney disease or end-stage renal disease. However, the clinical impact of sarcopenia in acute kidney injury (AKI) has not been studied extensively.
Methods
Among the patients diagnosed with severe AKI requiring continuous renal replacement therapy (CRRT) at multi-center from May 2017 to March 2018, Inbody, impedance body fat analyzer, was measured at the start of CRRT. We measured muscle mass, body fat mass, and water content using an inbody, and analyzed the long-term outcome including mortality.
Results
A total of 417 patients were enrolled. We calculated the dry weight of the patients using the Tahara edema index to rule out the possibility that the fluid overload would have caused the body weight to be higher than actually measured. The calculated dry body weight was used for the study. Sarcopenia was defined as an appendicular skeletal muscle mass (ASM)/body weight (ASM%) beyond two standard deviations below the gender-specific mean for healthy young adults according to nationwide health examinations of the Korean population (ASM% <29.0 in men or <22.9 in women was considered to indicate sarcopenia). Of these, 71 (17%) had sarcopenia. Patients diagnosed with sarcopenia were more males, older, with more diabetes and congestive heart failure. However, age-modified CCI, baseline renal function, APACHE II score, and SOFA score were not different between two groups. When mortality was defined as the primary outcome, mortality was significantly lower in the patients with sarcopenia (HR 0.47; 95% CI 0.24-0.91; P = 0.026).
Conclusion
In this study, muscle mass was directly measured in patients with AKI, and the relationship between sarcopenia and long-term outcome was investigated. Further studies on specific mechanisms and causes will be needed.