scholarly journals A Novel Mri-Method Allows a Rapid and Robust Assessment of Muscle Quantity and Quality in Hemodialysis Patients.

2021 ◽  
Author(s):  
Ainhoa Indurain ◽  
Jennifer Linge ◽  
Mikael Petersson Petersson ◽  
Thobias Romu ◽  
Fredrik Uhlin ◽  
...  
Keyword(s):  
Body Size ◽  
Hemodialysis Patients ◽  
Muscle Volume ◽  
Whole Body ◽  
Maintenance Hemodialysis ◽  
Fat Infiltration ◽  
Muscle Composition ◽  
Comorbidity Index ◽  
Muscle Fat Infiltration ◽  
Size Adjustment

Abstract BackgroundSarcopenia is a prevalent condition in patients on maintenance hemodialysis and associates with mortality. Research using magnetic resonance imaging (MRI) has demonstrated the importance of a proper body size-adjustment in the assessment of muscle mass, and that a muscle composition assessment including measurements of both muscle volume and fat infiltration improves the prediction of comorbidity and survival related to sarcopenia. Such combined muscle composition assessment has not previously been performed in hemodialysis patients.MethodsEleven hemodialysis patients were scanned using whole-body fat and water separated MRI and followed regarding survival and comorbidity for five years. Muscle composition was assessed using AMRA® Researcher. Using data from 9615 UK Biobank participants, sex and BMI-matched muscle volume z-scores and sex-adjusted muscle fat infiltration values were calculated for each patient. These measurements were then used for the calculation of a combined muscle score. Resulting three muscle measurements were associated with survival and comorbidity index.ResultsSix patients exhibited low muscle volume (muscle volume z-score <25th percentile (population wide)), and six patients presented with high muscle fat infiltration (>75th percentile (population wide)). During a 68-months follow-up, five patients died, four were transplanted and two remained on hemodialysis treatment. The combined muscle score was significantly associated with comorbidity index (p<0.05) and was highly predictive of survival (AUROC 0.97).ConclusionsThe combined assessment including both body size-adjusted muscle volume and muscle fat infiltration can be used to analyze muscle composition in hemodialysis patients. MRI based muscle composition assessment reflected comorbidity and predicted survival in hemodialysis patients.

scholarly journals On the Definition of Sarcopenia in the Presence of Aging and Obesity—Initial Results from UK Biobank

2019 ◽  
Vol 75 (7) ◽  
pp. 1309-1316 ◽  
Author(s):  
Jennifer Linge ◽  
Steven B Heymsfield ◽  
Olof Dahlqvist Leinhard
Keyword(s):  
Body Size ◽  
Grip Strength ◽  
Normal Weight ◽  
Hand Grip Strength ◽  
Stair Climbing ◽  
Hand Grip ◽  
Functional Measure ◽  
Magnetic Resonance Imaging Mri ◽  
Muscle Fat Infiltration ◽  
Size Adjustment

Abstract Background Current consensus is to combine a functional measure with muscle quantity to assess/confirm sarcopenia. However, the proper body size adjustment for muscle quantity is debated and sarcopenia in obesity is not well described. Further, functional measures are not muscle-specific or sensitive to etiology, and can be confounded by, for example, fitness/pain. For effective detection/treatment/follow-up, muscle-specific biomarkers linked to function are needed. Methods Nine thousand six hundred and fifteen participants were included and current sarcopenia thresholds (EWGSOP2: DXA, hand grip strength) applied to investigate prevalence. Fat-tissue free muscle volume (FFMV) and muscle fat infiltration (MFI) were quantified through magnetic resonance imaging (MRI) and sex-and-body mass index (BMI)-matched virtual control groups (VCGs) were used to extract each participant’s FFMV/height2 z-score (FFMVVCG). The value of combining FFMVVCG and MFI was investigated through hospital nights, hand grip strength, stair climbing, walking pace, and falls. Results Current thresholds showed decreased sarcopenia prevalence with increased BMI (underweight 8.5%/normal weight 4.3%/overweight 1.1%/obesity 0.1%). Contrary, the prevalence of low function increased with increasing BMI. Previously proposed body size adjustments (division by height2/weight/BMI) introduced body size correlations of larger/similar magnitude than before. VCG adjustment achieved normalization and strengthened associations with hospitalization/function. Hospital nights, low hand grip strength, slow walking pace, and no stair climbing were positively associated with MFI (p &lt; .05) and negatively associated with FFMVVCG (p &lt; .01). Only MFI was associated with falls (p &lt; .01). FFMVVCG and MFI combined resulted in highest diagnostic performance detecting low function. Conclusions VCG-adjusted FFMV enables proper sarcopenia assessment across BMI classes and strengthened the link to function. MFI and FFMV combined provides a more complete, muscle-specific description linked to function enabling objective sarcopenia detection.

scholarly journals Implementation and effectiveness of an intensive education program on phosphate control among hemodialysis patients: a non-randomized, single-arm, single-center trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jinmei Yin ◽  
Jun Yin ◽  
Rongli Lian ◽  
Peiqiu Li ◽  
Jing Zheng
Keyword(s):  
Education Program ◽  
Hemodialysis Patients ◽  
Serum Phosphorus ◽  
Phosphate Binders ◽  
Maintenance Hemodialysis ◽  
Single Center ◽  
Clinical Trial Registry ◽  
Before And After ◽  
Intensive Education ◽  
Phosphate Control

Abstract Background Hyperphosphatemia is a common complication in patients on maintenance hemodialysis. Patients’ adherence to phosphorus control can be improved by consistent education. However, few studies have focused on the model construction and effects of health education on phosphate control for hemodialysis patients. Objective To develop an intensive education program focusing on phosphate control among hemodialysis patients and to analyze the effectiveness of this program. Design A non-randomized, single-arm, single-center trial lasting for 6 months. Setting This program was conducted in a hemodialysis center in a teaching hospital in Zhuhai, China. Participants Patients on maintenance hemodialysis with hyperphosphatemia. Methods An intensive hyperphosphatemia control education program lasting for 6 months was conducted among 366 hemodialysis patients applying the First Principles of Instruction model, which focused on mastering four stages: (a) activation of prior experience, (b) demonstration of skills, (c) application of skills and (d) integration of these skills into real-world activities. The controlled percentage of serum phosphorus, knowledge of hyperphosphatemia, and adherence to phosphate binders before and after the education program were assessed. Results The proportion of controlled serum phosphorus was significantly increased from 43.5 to 54.9% (P<0.001). The scores on the knowledge of phosphate control were improved significantly from 59.0 ± 18.9 to 80.6 ± 12.4 (P < 0.001). The proportion of high adherence to phosphate binders was increased dramatically from 21.9 to 44.5% (P < 0.001). Conclusion The intensive education program can effectively improve serum phosphorus, knowledge of hyperphosphatemia, and adherence to phosphate binders among hemodialysis patients. Trial registration Chinese Clinical Trial Registry, ChiCTR2100042017. Retrospectively registered January 12th, 2021.

scholarly journals Antibody response to BNT162b2 vaccine in maintenance hemodialysis patients

2021 ◽  
Author(s):  
Philippe Attias ◽  
Hamza Sakhi ◽  
Philippe Rieu ◽  
Arvish Soorkia ◽  
David Assayag ◽  
...  
Keyword(s):  
Antibody Response ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Maintenance Hemodialysis Patients

scholarly journals POS-542 The Epidemiology and outcome of COVID-19 among maintenance hemodialysis patients: a retrospective study from a dialysis network in India

2021 ◽  
Vol 6 (4) ◽  
pp. S236-S237
Author(s):  
S. Sankarasubbaiyan ◽  
G. Mallikarjun ◽  
H. Mohammed S ◽  
V. Sonawane ◽  
K. Kaparaboina K. K ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Maintenance Hemodialysis Patients

scholarly journals Comorbidity burden may explain adiponectin’s paradox as a marker of increased mortality risk in hemodialysis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ilia Beberashvili ◽  
Tamar Cohen-Cesla ◽  
Amin Khatib ◽  
Ramzia Abu Hamad ◽  
Ada Azar ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Maintenance Hemodialysis ◽  
Blood Levels ◽  
Low Concentrations ◽  
Comorbidity Burden ◽  
All Cause Mortality ◽  
Markers Of Oxidative Stress ◽  
Comorbidity Index ◽  
Antiinflammatory Effects ◽  
High Comorbidity

AbstractDespite experimental evidence of beneficial metabolic, antiatherosclerotic and antiinflammatory effects of the 30 kDa adipokine, adiponectin, maintenance hemodialysis (MHD) patients with high adiponectin blood levels have paradoxically high mortality rates. We aimed to examine the direction of the associations between adiponectin and all-cause and cardiovascular mortality as well as with markers of oxidative stress, inflammation and nutrition in MHD patients with varying degrees of comorbidities. A cohort of 261 MHD patients (mean age 68.6 ± 13.6 years, 38.7% women), grouped according to baseline comorbidity index (CI) and serum adiponectin levels, were followed prospectively for six years. High and low concentrations were established according to median CI and adiponectin levels and cross-classified. Across the four CI-adiponectin categories, the group with low comorbidities and high adiponectin exhibited the best outcomes. Conversely, the high comorbidity group with high adiponectin levels had the lowest survival rate in both all-cause mortality (log rankχ2 = 23.74, p < 0.001) and cardiovascular mortality (log rankχ2 = 34.16, p < 0.001). Further data adjustment for case-mix covariates including fat mass index did not substantially affect these results. In conclusion, the direction of adiponectin’s prognostic associations in MHD patients is inverse in those with few comorbidities and direct in those with many comorbidities.

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