Kidney Week

Abstract: TH-PO454

Prognostic Value of Skeletal Muscle Mass and Body Mass Index in PKD

Session Information

• Cystic Kidney Diseases: Clinical Assessment and Therapeutic Directions
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic

Authors

• Im, Dha Woon, Eulji University Uijeongbu Eulji Medical Center, Uijeongbu, Gyeonggi-do, Korea (the Republic of)

Dha Woon Im, MD

• Jung, Jiyun, Dongguk University College of Medicine, Gyeongju, Gyeongsangbuk-do, Korea (the Republic of)

Jiyun Jung, PhD

• Kim, Yon Su, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Yon Su Kim, MD, PhD

• Oh, Kook-Hwan, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Kook-Hwan Oh, MD, PhD

• Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Dong Ki Kim, MD, PhD

• Lee, Hajeong, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Hajeong Lee, MD, PhD

• Han, Seung Seok, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Seung Seok Han, MD, PhD

• Kang, Eunjeong, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Eunjeong Kang, MD, PhD

• Park, Sehoon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Sehoon Park, MD, PhD

• Shin, Sung Joon, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)

Sung Joon Shin, MD, PhD

• Lee, Jangwook, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)

Jangwook Lee, MD

• Song, Jeongin, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)

Jeongin Song, MD

• Park, Jae Yoon, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)

Jae Yoon Park, MD, PhD

• Kim, Yong Chul, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Yong Chul Kim, MD, PhD

Background

Low muscle mass is a well-established risk factor for the progression of chronic kidney disease (CKD). However, little is known about the impact of muscle mass on mortality in patients with autosomal dominant polycystic kidney disease (ADPKD). This study aimed to investigate the effect of muscle mass on mortality in individuals with ADPKD.

Methods

We collected clinical information on 1273 ADPKD patients from Seoul National University Hospital between 2006 and 2019, and obtained CT image at lumbar 3rd vertebra to measure the skeletal muscle area (SMA) by artificial intelligence. SMA was classified as low attenuation muscle area (LAMA) and normal attenuation muscle area (NAMA) according to muscle quality, and divided by height² to adjust the body size. Tracked through 2020, we estimated hazard ratio (HR) and 95% confidence interval (CI) on Cox-proportional hazard model adjusted by sex, age, MAYO classification, serum creatinine, blood urea nitrogen, and glucose.

Results

During the average of 5.14 years, more than half of the patients were female, and the mean (standard deviation) age was 47.2 (12.6) years. We observed 55 deaths, and the average of SMA/height², NAMA/height², and LAMA/height² was 45.4 cm²/m², 35.5 cm²/m², 9.9 cm²/m², respectively. We found significant protective effects of SMA (HR 0.94, 95% CI 0.89–0.98) and NAMA (HR 0.94, 95% CI 0.90–0.97) on mortality while weak adverse effect in LAMA (HR 1.06, 95% CI 1.00–1.12). According to body mass index classification, those who had normal weight (18.5≤BMI<25) showed prominently positive health effects with NAMA increase (HR 0.95, 95% CI 0.91–0.99).

Conclusion

In ADPKD, greater muscle mass, especially high-quality muscle mass, is associated with a reduced risk of mortality.

Survival probability according to quartile of (A) skeletal muscle area (SMA)/height², (B) normal attenuation muscle area (NAMA)/height², (C) low attenuation muscle area (LAMA) /height², and (D) NAMA/LAMA.