Journal article
Sarcopenia is associated with survival in patients awaiting kidney transplant
Surgery, Vol.179, 108800
03/2025
DOI: 10.1016/j.surg.2024.08.028
PMCID: PMC11786994
PMID: 39304441
Abstract
The relationship of sarcopenia to frailty and other survival determinants in patients waitlisted for kidney transplant is not well characterized. Our goal was to evaluate the relationship of muscle area to functional and frailty metrics and its impact on survival in patients waitlisted for kidney transplant.
Among 303 consecutively listed transplant candidates, 172 had a computed scan within 3 months of frailty and biochemical testing that permitted muscle area evaluation. Third lumbar level psoas muscle indices (total bilateral psoas area/height2) were calculated. Testing included frailty metrics, treadmill and pedometer ability, troponin, and brain natriuretic peptide levels. Associations between muscle area, demographic, biochemical, and frailty measures were analyzed. Log-rank test was used to evaluate waitlist survival on the basis of muscle area, and multivariate Cox proportional hazards modeling was used to evaluate factors independently associated with survival.
Demographic factors associated with third lumbar level psoas muscle indices include male sex (P < .001), race (P = .02), age (P = .004), and body mass index (P < .0001). Grip strength, treadmill ability, and Sit-Stands positively correlated with third lumbar level psoas muscle indices (P < .01). Brain natriuretic peptide and Up and Go negatively correlated with third lumbar level psoas muscle indices (P < .01). Survival was significantly associated with third lumbar level psoas muscle indices (P = 0.02). Treadmill ability, Sit-Stands, Up and Go, race and muscle area were most closely associated with waitlist survival on multivariate modeling.
Sarcopenia as assessed with muscle area measurements is independently associated with kidney waitlist survival. Functional ability and muscle area may be overlapping, but noncongruent, determinants of waitlist outcomes and may need to be individually assessed to create the most predictive survival model.
Details
- Title: Subtitle
- Sarcopenia is associated with survival in patients awaiting kidney transplant
- Creators
- Julia Wendland - University of IowaAbhinav Seth - University of IowaPatrick Ten Eyck - University of Iowa, BiostatisticsJude Longo - Radiology Department, Veterans Affairs Medical Center, Iowa City, IAGrace Binns - Transplant Department, Veterans Affairs Medical Center, Iowa City, IAM. Lee Sanders - Transplant Department, Veterans Affairs Medical Center, Iowa City, IAJodell L. Hornickel - Transplant Department, Veterans Affairs Medical Center, Iowa City, IAMelissa Swee - University of Iowa, NephrologyRoberto Kalil - University of Maryland Medical CenterDaniel A. Katz - Transplant Department, Veterans Affairs Medical Center, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Surgery, Vol.179, 108800
- DOI
- 10.1016/j.surg.2024.08.028
- PMID
- 39304441
- PMCID
- PMC11786994
- NLM abbreviation
- Surgery
- ISSN
- 0039-6060
- eISSN
- 1532-7361
- Publisher
- Elsevier Inc
- Grant note
- University of Iowa Clinical and Translational Science Award-National Institutes of Health: UM1TR004 403
Funding/Support This study was supported in part by The University of Iowa Clinical and Translational Science Award-National Institutes of Health (UM1TR004 403) .
- Language
- English
- Electronic publication date
- 09/19/2024
- Date published
- 03/2025
- Academic Unit
- Stead Family Department of Pediatrics; Biostatistics; Surgery; Nephrology; Internal Medicine; Design Biostat and Ethics
- Record Identifier
- 9984704840902771
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