Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure
<b>Background:</b> Sarcopenia involves an age-related decline in skeletal muscle mass with functional disability or low muscle strength. Vascular calcification (VC) occurs commonly in patients with chronic kidney disease, in whom it is associated with cardiovascular disease. We aimed to...
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doaj-b69376939d5e45099207b106e5909e8a2021-08-26T13:55:53ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103698369810.3390/jcm10163698Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access FailureSeok-hyung Kim0Gwangho Choi1Youngjin Song2Hojung Yoon3Hae Min Jeong4Jae Eon Gu5Miyeun Han6Jongho Heo7Jeong-Ju Yoo8Jong-woo Yoon9Hyunsuk Kim10Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, KoreaDepartment of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, KoreaDepartment of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, KoreaDepartment of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, KoreaDepartment of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, KoreaDepartment of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, KoreaDepartment of Internal Medicine, Hangang Sacred Heart Hospital, Seoul 07247, KoreaNational Assembly Futures Institute, Seoul 07233, KoreaDepartment of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon 14584, KoreaDepartment of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, KoreaDepartment of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea<b>Background:</b> Sarcopenia involves an age-related decline in skeletal muscle mass with functional disability or low muscle strength. Vascular calcification (VC) occurs commonly in patients with chronic kidney disease, in whom it is associated with cardiovascular disease. We aimed to investigate the correlations of low muscle mass with the quantified vascular calcification score (VCS) of the arm of vascular access, as well as whether low muscle mass is associated with the incidence of vascular access failure. <b>Methods:</b> The VCS was measured on non-contrast, arm computed tomography using the Agatston method. The lower muscle mass (LMM) group comprised subjects whose skeletal muscle mass of the lower extremities, as measured using bioelectrical impedance, was lower than the median. Higher VC was defined as a score of 500 or above, corresponding to the highest 40% of VCS. The relationship between LMM and VC was explored using univariate and multivariate logistic regression analyses. <b>Results:</b> Seventy-five patients were included, of whom forty-two (56.0%) were men. The median age was 64 years (interquartile range 58–72 years). Of the 75 patients, 73 satisfied the diagnostic criteria for sarcopenia. The median hemodialysis vintage was 49.4 months (range 32.1–99.2 months). No significant differences were found between the non-LMM and LMM groups in sex, end-stage renal disease etiology, and type of vascular access, although the LMM group showed significantly older age and hemodialysis vintage. LMM presented a significant association with VC (hazard ratio (HR) 3.562; 95% CI, 1.341–9.463; <i>p</i> = 0.011). Upon adjustment for hemodialysis vintage, diabetes, and systolic blood pressure, LMM demonstrated an independent association with VC (HR, 10.415; 95% CI, 2.357–46.024; <i>p</i> = 0.002). The risk of vascular access failure was higher in the LMM group (HR, 3.652; 95%, CI 1.135–11.749; <i>p</i> = 0.03). VC was a full mediator in the relationship of LMM with recurrent vascular access failure. <b>Conclusions:</b> We quantified LMM via bioimpedance analysis and found a heretofore-unreported association between LMM and vascular access failure. LMM increases the risk of VC and has the potential to predict vascular access failure.https://www.mdpi.com/2077-0383/10/16/3698hemodialysisvascular calcificationsarcopeniavascular access failure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Seok-hyung Kim Gwangho Choi Youngjin Song Hojung Yoon Hae Min Jeong Jae Eon Gu Miyeun Han Jongho Heo Jeong-Ju Yoo Jong-woo Yoon Hyunsuk Kim |
spellingShingle |
Seok-hyung Kim Gwangho Choi Youngjin Song Hojung Yoon Hae Min Jeong Jae Eon Gu Miyeun Han Jongho Heo Jeong-Ju Yoo Jong-woo Yoon Hyunsuk Kim Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure Journal of Clinical Medicine hemodialysis vascular calcification sarcopenia vascular access failure |
author_facet |
Seok-hyung Kim Gwangho Choi Youngjin Song Hojung Yoon Hae Min Jeong Jae Eon Gu Miyeun Han Jongho Heo Jeong-Ju Yoo Jong-woo Yoon Hyunsuk Kim |
author_sort |
Seok-hyung Kim |
title |
Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure |
title_short |
Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure |
title_full |
Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure |
title_fullStr |
Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure |
title_full_unstemmed |
Low Muscle Mass in Patients Receiving Hemodialysis: Correlations with Vascular Calcification and Vascular Access Failure |
title_sort |
low muscle mass in patients receiving hemodialysis: correlations with vascular calcification and vascular access failure |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-08-01 |
description |
<b>Background:</b> Sarcopenia involves an age-related decline in skeletal muscle mass with functional disability or low muscle strength. Vascular calcification (VC) occurs commonly in patients with chronic kidney disease, in whom it is associated with cardiovascular disease. We aimed to investigate the correlations of low muscle mass with the quantified vascular calcification score (VCS) of the arm of vascular access, as well as whether low muscle mass is associated with the incidence of vascular access failure. <b>Methods:</b> The VCS was measured on non-contrast, arm computed tomography using the Agatston method. The lower muscle mass (LMM) group comprised subjects whose skeletal muscle mass of the lower extremities, as measured using bioelectrical impedance, was lower than the median. Higher VC was defined as a score of 500 or above, corresponding to the highest 40% of VCS. The relationship between LMM and VC was explored using univariate and multivariate logistic regression analyses. <b>Results:</b> Seventy-five patients were included, of whom forty-two (56.0%) were men. The median age was 64 years (interquartile range 58–72 years). Of the 75 patients, 73 satisfied the diagnostic criteria for sarcopenia. The median hemodialysis vintage was 49.4 months (range 32.1–99.2 months). No significant differences were found between the non-LMM and LMM groups in sex, end-stage renal disease etiology, and type of vascular access, although the LMM group showed significantly older age and hemodialysis vintage. LMM presented a significant association with VC (hazard ratio (HR) 3.562; 95% CI, 1.341–9.463; <i>p</i> = 0.011). Upon adjustment for hemodialysis vintage, diabetes, and systolic blood pressure, LMM demonstrated an independent association with VC (HR, 10.415; 95% CI, 2.357–46.024; <i>p</i> = 0.002). The risk of vascular access failure was higher in the LMM group (HR, 3.652; 95%, CI 1.135–11.749; <i>p</i> = 0.03). VC was a full mediator in the relationship of LMM with recurrent vascular access failure. <b>Conclusions:</b> We quantified LMM via bioimpedance analysis and found a heretofore-unreported association between LMM and vascular access failure. LMM increases the risk of VC and has the potential to predict vascular access failure. |
topic |
hemodialysis vascular calcification sarcopenia vascular access failure |
url |
https://www.mdpi.com/2077-0383/10/16/3698 |
work_keys_str_mv |
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