Sharmela Sahathevan1, Ban-Hock Khor2, Chai Hong Yeong3, Teik Hin Tan4, Abdul Kareem Meera Mohaideen3, Hi Ming Ng3, Gild Rick Ong5, Sreelakshmi Sankara Narayanan5, Abdul Halim Abdul Gafor2, Bak Leong Goh6, Boon Cheak Bee7, Zulfitri 'Azuan Mat Daud8, Karuthan Chinna3, Tilakavati Karupaiah5. 1. Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. 2. Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. 3. School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Selangor, Malaysia. 4. Nuclear Medicine Centre, Sunway Medical Centre, Selangor, Malaysia. 5. School of BioSciences, Faculty of Health & Medical Sciences, Taylor's University, Selangor, Malaysia. 6. Department of Nephrology, Serdang Hospital, Selangor, Malaysia. 7. Department of Nephrology, Selayang Hospital, Selangor, Malaysia. 8. Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
Abstract
BACKGROUND: Muscle wasting, prevalent in maintenance hemodialysis (HD) patients diagnosed with protein-energy wasting, represents an assessment challenge in the outpatient HD setting. Quadriceps muscle thickness (QMT) and cross-sectional area (CSA) assessment by ultrasound (US) is a potential surrogate measure for muscle wasting. We aimed to determine the validity of US to measure QMT and CSA against the gold standard-computed tomography (CT). METHODS: Twenty-six patients on HD underwent US and CT scans on the same day, postdialysis session. QMT for rectus femoris (RF) and vastus intermedius (VI) muscles was taken at the midpoint (MID) and two-thirds (2/3) of both thighs and CSA of the RF muscle (RFCSA ), respectively. Correlation between US and CT measurements was determined by intraclass correlation coefficient (ICC) and Bland-Altman plot. RESULTS: ICC (95% CI) computed between US and CT was 0.94 (0.87-0.97), 0.97 (0.93-0.99), 0.94 (0.87-0.97), 0.94 (0.86-0.97), and 0.92 (0.83-0.97) for RFMID , VIMID, RF2/3, VI2/3 , and RFCSA , respectively (all P < 0.001). Bland-Altman analysis indicated no bias in agreement between both methods. CONCLUSION: The US imaging offers a valid and quick bedside assessment approach to assess muscle wasting in HD patients.
BACKGROUND:Muscle wasting, prevalent in maintenance hemodialysis (HD) patients diagnosed with protein-energy wasting, represents an assessment challenge in the outpatientHD setting. Quadriceps muscle thickness (QMT) and cross-sectional area (CSA) assessment by ultrasound (US) is a potential surrogate measure for muscle wasting. We aimed to determine the validity of US to measure QMT and CSA against the gold standard-computed tomography (CT). METHODS: Twenty-six patients on HD underwent US and CT scans on the same day, postdialysis session. QMT for rectus femoris (RF) and vastus intermedius (VI) muscles was taken at the midpoint (MID) and two-thirds (2/3) of both thighs and CSA of the RF muscle (RFCSA ), respectively. Correlation between US and CT measurements was determined by intraclass correlation coefficient (ICC) and Bland-Altman plot. RESULTS: ICC (95% CI) computed between US and CT was 0.94 (0.87-0.97), 0.97 (0.93-0.99), 0.94 (0.87-0.97), 0.94 (0.86-0.97), and 0.92 (0.83-0.97) for RFMID , VIMID, RF2/3, VI2/3 , and RFCSA , respectively (all P < 0.001). Bland-Altman analysis indicated no bias in agreement between both methods. CONCLUSION: The US imaging offers a valid and quick bedside assessment approach to assess muscle wasting in HDpatients.
Authors: Wei Luo; Ruidong Zhang; Da He; Zhenyi Sun; Yunlong Zhou; Li Cheng; Hongbo Li Journal: Comput Math Methods Med Date: 2022-01-19 Impact factor: 2.238