J Greg Terry
Investigator
Last active: 9/4/2019

Abdominal lean muscle is associated with lower mortality among kidney waitlist candidates.

Locke JE, Carr JJ, Nair S, Terry JG, Reed RD, Smith GD, Segev DL, Kumar V, Lewis CE
Clin Transplant. 2017 31 (3)

PMID: 28075034 · PMCID: PMC5336401 · DOI:10.1111/ctr.12911

Morphometric assessments, such as muscle density and body fat distribution, have emerged as strong predictors of cardiovascular risk and postoperative morbidity and mortality. To date, no study has examined morphometric mortality risk prediction among kidney transplant (KT) candidates. KT candidates, waitlisted 2008-2009, were identified (n=96) and followed to the earliest of transplant, death, or administrative end of study. Morphometric measures, including abdominal adipose tissue, paraspinous and psoas muscle composition, and aortic calcification, were measured from CTs. Risk of waitlist mortality was examined using Cox proportional hazard regression. On adjusted analyses, radiologic measures remained independently and significantly associated with lower waitlist mortality; the addition of radiologic measures significantly improved model predictive ability over models containing traditional risk factors alone (net reclassification index: 0.56, 95% CI: 0.31-0.75). Higher psoas muscle attenuation (indicative of leaner muscle) was associated with decreased risk of death (aHR: 0.93, 95% CI: 0.91-0.96, P<.001), and for each unit increase in lean paraspinous volume, there was an associated 2% decreased risk for death (aHR: 0.98, 95% CI: 0.96-0.99, P=.03). Radiologic measures of lean muscle mass, such as psoas muscle attenuation and paraspinous lean volume, may improve waitlist mortality risk prediction and candidate selection.

© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

MeSH Terms (17)

Abdominal Fat Adult Female Follow-Up Studies Humans Kidney Transplantation Male Middle Aged Muscle, Skeletal Muscle Strength Prognosis Psoas Muscles Retrospective Studies Risk Factors Survival Rate Thinness Waiting Lists

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