Kidney Week

Abstract: TH-PO055

Impacts of Skeletal Muscle Mass and Quality on Kidney Recovery after AKI Receiving Continuous Kidney Replacement Therapy

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Paek, Jin hyuk, Keimyung University Dongsan Medical Center, Daegu, Korea (the Republic of)

Jin hyuk Paek, MD, PhD

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

Jiyun Jung, PhD

• Lim, Jeong-Hoon, Kyungpook National University School of Medicine, Daegu, Korea (the Republic of)

Jeong-Hoon Lim, MD, PhD

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

Yong Chul Kim, MD, PhD

• Ban, Tae Hyun, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)

Tae Hyun Ban, MD, PhD

• Lee, Soyoung, Daejeon Eulji University Hospital, Daejeon, Korea (the Republic of)

Soyoung Lee, MD

• Kim, Kipyo, Inha University School of Medicine, Incheon, Korea (the Republic of)

Kipyo Kim, MD, PhD

• Kim, Hyosang, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)

Hyosang Kim, MD, PhD

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

Jeongin Song, MD

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

Jangwook Lee, MD

• Shin, Sung Joon, Dongguk University College of Medicine, Gyeongju, Gyeongsangbuk-do, Korea (the Republic of)

Sung Joon Shin, MD, PhD

• Macedo, Etienne, University of California San Diego Department of Medicine, La Jolla, California, United States

Etienne Macedo, MD, PhD, FASN

• Park, Woo Yeong, Keimyung University Dongsan Medical Center, Daegu, Korea (the Republic of)

Woo Yeong Park, MD, PhD

• Park, Jae Yoon, Dongguk University College of Medicine, Gyeongju, Gyeongsangbuk-do, Korea (the Republic of)

Jae Yoon Park, MD, PhD

Background

Recent study revealed that muscle mass was significant determinant of mortality in patients with patients with severe acute kidney injury (AKI) requiring continuous kidney replacement therapy (CKRT). However, there is little evidence on how muscle mass affects kidney recovery in these patients.

Methods

We collected 1,771 AKI patients who underwent CKRT from eight medical centers between 2006 and 2021. The skeletal muscle area (SMA) was measured from the automated software from CT images at 3rd lumbar vertebra within 15 days of CKRT initiation, and classified as normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA) according to muscle density. We used Cox proportional hazard model to investigate the effects of muscle index adjusted by height² on kidney recovery. In addition, Fine-Gray sub-distribution hazard models were used to consider the competing risks on mortality.

Results

The average duration of dialysis was 10.7 days, and 729 patients (41.2%) were discharged from the hospital independent of dialysis. The average of SMA/height², NAMA/height², and LAMA/height² were 41.2cm², 19.0cm², and 22.2cm², respectively. SMA/height² (HR 1.01, 95% CI 1.00-1.02, p=0.03), NAMA/height² (HR 1.02, 95%CI 1.01-1.03, p < 0.01), and NAMA/LAMA ratio (HR 1.09, 95% CI 1.01-1.17, p = 0.03) were associated with an increased probability of dialysis independence (DI) at discharge. In addition, while SMA/height² was identified as a factor that increased the probability of DI, it was not associated with mortality in Fine-Gray sub-distribution hazard models.

Conclusion

The amount of skeletal muscle mass was related to kidney recovery after AKI requiring CKRT. And muscles of normal density particularly supported these results. Furthermore, after considering mortality as a competing risk, an increase in skeletal muscle mass was associated with a higher probability of DI.