Lean tissue, body cell mass seen as predictors of AKI requiring kidney replacement therapy
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Investigators analyzing muscle mass and outcomes of patients with AKI who received kidney replacement therapy identified an association between lower lean tissue index and body cell mass index before KRT and short-term prognosis.
“Previous studies have mostly focused on the nutritional parameters of body composition and prognosis in the maintenance of hemodialysis patients,” wrote Buyun Wu, MD, of Nanjing Medical University, and colleagues. “But the data in patients with AKI requiring kidney replacement therapy was scarce.”
Researchers enrolled 152 patients with severe AKI treated with KRT including 99 men and 53 women, with an average age of 62.7 years. Patients were assessed by body composition analysis, including lean tissue index and body cell mass index before KRT and on the third and seventh day after the initiation of KRT. The association between mortality and predictors was analyzed using Cox regression.
Collected data on mortality rates after KRT showed a 28-day mortality rate of 46.7% and a 1-year mortality rate of 60.5%. Using Cox regression, investigators did not find an association between fat mass index, lean tissue index and body cell mass index before KRT or at the third day after prognosis. Investigators found lower lean tissue index and body cell mass index before KRT were significantly associated with 28-day mortality and 90-day death or dialysis dependency.
Researchers identified a limitation in the small sample size; however, they found statistical significance in the relationship between body composition and prognosis.
“ ... [Lean tissue index] LTI and [body cell mass index] BCMI values at day 7 had good predictability for 90-day mortality,” wrote Wu and colleagues. “These results suggest that body composition analysis is valuable to document the lean body mass and its loss in the patients with AKI requiring KRT.”
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