Kidney Week

Abstract: TH-PO280

Decreased Skeletal Muscle Mass as a Risk Factor for the Progression of Peripheral Artery Disease (PAD) in Patients Receiving Maintenance Hemodialysis: 10-Year Outcomes of the Q-Cohort Study

Session Information

• Hemodialysis and Frequent Dialysis - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Shojima, Masumi, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Masumi Shojima, MD

• Yamada, Shunsuke, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Shunsuke Yamada, MD, PhD

• Suenaga, Tatsuya, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Tatsuya Suenaga, MD

• Okamura, Kazuhiro, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Kazuhiro Okamura, MD

• Kitamura, Hiromasa, Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan

Hiromasa Kitamura, MD, PhD

• Hiyamuta, Hiroto, Department of Nephrology, Steel Memorial Yawata Hospital, Fukuoka, Japan

Hiroto Hiyamuta, MD, PhD

• Taniguchi, Masatomo, Fukuoka Renal Clinic, Fukuoka, Japan

Masatomo Taniguchi, MD, PhD

• Tsuruya, Kazuhiko, Department of Nephrology, Nara Medical University, Kashihara, Japan

Kazuhiko Tsuruya, MD, PhD

• Kitazono, Takanari, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Takanari Kitazono, MD, PhD

• Nakano, Toshiaki, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Toshiaki Nakano, MD, PhD

Background

Peripheral arterial disease (PAD) is a life-threatening complication in patients undergoing hemodialysis. It is unclear whether sarcopenia, as evidenced by a lower value of skeletal muscle mass surrogates, is a risk factor for PAD.

Methods

A total of 3,506 patients receiving hemodialysis registered in the multicenter, prospective, observational study were followed up for 10 years. The primary outcome was an intervention for PAD composed of endovascular therapy, revascularization, and amputation. The main exposure was the modified creatinine index, a surrogate of skeletal muscle mass calculated by age, sex, pre-dialysis serum creatinine, and Kt/V for urea. The patients were divided into sex-specific quartiles (Q1-Q4) according to the modified creatinine index level at baseline. Cox proportional hazard risk models were employed to estimate the intervention risks for PAD.

Results

In total, 257 patients required intervention for PAD during a median follow-up period of 8.2 years. The multivariable-adjusted Cox proportional hazards risk model showed that the risks of intervention for PAD in the lower quartiles (Q1 and Q2) were significantly (P<0.05) higher than the highest quartile (Q4): hazard ratio (95% confidence interval) for Q1 and Q2 were 1.75 (1.01–3.04) and 1.63 (1.04–2.58), respectively. Each 1 mg/kg/day decrease in the modified creatinine index was significantly (P=0.017) associated with the elevated risk of the intervention for PAD: hazard ratio (95% confidence interval) was 1.11 (1.01–1.22).

Conclusion

Sarcopenia, as expressed by a lower modified creatinine index level, was an independent risk factor for intervention for PAD in patients undergoing hemodialysis.