Seok Hui Kang1, A Young Kim1, Jun Young Do1. 1. Division of Nephrology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea.
Abstract
BACKGROUND: Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PD patients. METHODS: Total 528 incident PD patients were included. Lean mass was measured using dual energy X-ray absorptiometry. Appendicular lean mass (ALM) was calculated using the sum for both upper and lower extremities. Each ALM index was calculated using ALM per body weight (ALM/BW), height squared (ALM/Ht2), or body mass index (ALM/BMI). Limb/trunk lean mass (LTLM) ratio was defined as the sum for both upper and lower extremities divided by trunk lean mass. RESULTS: A total of 528 patients were analyzed men: 286, women: 242. In area under the receiver operating characteristic curve analyses, LTLM alone was associated with 1 year mortality. In the LTLM ratio, the cut-off value for 1-year mortality was ≤ 0.829 in men and ≤ 0.717 in women, respectively. In both sexes, LTLM ratio alone showed statistical significance in all-cause mortality in both univariate and multivariate Cox-regression analyses. Compared with other indices, the LTLM ratio was independent of edema and fat in both sexes. Edema- and C-reactive protein-adjusted correlation analysis showed that LTLM ratio alone was associated with serum albumin in men. Although statistical significance was not obtained for women, the correlation coefficient was highest for the LTLM ratio compared with other indices. CONCLUSION: Among various indices using lean mass, LTLM ratio was independent of volume status and fat mass and was associated with mortality in incident PD patients.
BACKGROUND: Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PDpatients. METHODS: Total 528 incident PDpatients were included. Lean mass was measured using dual energy X-ray absorptiometry. Appendicular lean mass (ALM) was calculated using the sum for both upper and lower extremities. Each ALM index was calculated using ALM per body weight (ALM/BW), height squared (ALM/Ht2), or body mass index (ALM/BMI). Limb/trunk lean mass (LTLM) ratio was defined as the sum for both upper and lower extremities divided by trunk lean mass. RESULTS: A total of 528 patients were analyzed men: 286, women: 242. In area under the receiver operating characteristic curve analyses, LTLM alone was associated with 1 year mortality. In the LTLM ratio, the cut-off value for 1-year mortality was ≤ 0.829 in men and ≤ 0.717 in women, respectively. In both sexes, LTLM ratio alone showed statistical significance in all-cause mortality in both univariate and multivariate Cox-regression analyses. Compared with other indices, the LTLM ratio was independent of edema and fat in both sexes. Edema- and C-reactive protein-adjusted correlation analysis showed that LTLM ratio alone was associated with serum albumin in men. Although statistical significance was not obtained for women, the correlation coefficient was highest for the LTLM ratio compared with other indices. CONCLUSION: Among various indices using lean mass, LTLM ratio was independent of volume status and fat mass and was associated with mortality in incident PDpatients.
Authors: Anneke Kramer; Maria Pippias; Vianda S Stel; Marjolein Bonthuis; José Maria Abad Diez; Nikolaos Afentakis; Ramón Alonso de la Torre; Patrice Ambuhl; Boris Bikbov; Encarnación Bouzas Caamaño; Ivan Bubic; Jadranka Buturovic-Ponikvar; Fergus J Caskey; Pablo Castro de la Nuez; Harijs Cernevskis; Frederic Collart; Jordi Comas Farnés; Maria de Los Ángeles Garcia Bazaga; Johan De Meester; Manuel Ferrer Alamar; Patrik Finne; Liliana Garneata; Eliezer Golan; James G Heaf; Marc Hemmelder; Kyriakos Ioannou; Nino Kantaria; Mykola Kolesnyk; Reinhard Kramar; Mathilde Lassalle; Visnja Lezaic; Frantisek Lopot; Fernando Macário; Angela Magaz; Eduardo Martín-Escobar; Wendy Metcalfe; Mai Ots-Rosenberg; Runolfur Palsson; Celestino Piñera Celestino; Halima Resić; Boleslaw Rutkowski; Carmen Santiuste de Pablos; Viera Spustová; Maria Stendahl; Ariana Strakosha; Gültekin Süleymanlar; Marta Torres Guinea; Anna Varberg Reisæter; Evgueniy Vazelov; Edita Ziginskiene; Ziad A Massy; Christoph Wanner; Kitty J Jager; Marlies Noordzij Journal: Clin Kidney J Date: 2016-01-31