This study examines the relationship between muscle mass and frailty in patients undergoing haemodialysis (a treatment for kidney failure). Researchers used ultrasound to measure the thickness of the quadriceps muscle in 223 participants. They compared these measurements to various frailty assessment tools. They found that muscle thickness was linked to higher frailty scores, but this relationship varied depending on the assessment tool used and was not independent of other factors. The study suggests that while ultrasound measurements can provide useful information about muscle mass, further research is needed to understand their value in assessing frailty in haemodialysis patients.
Abstract
Background
Ultrasonographic quantitation of quadriceps muscle mass is increasingly used for assessment of sarcopenia, but its relationship with frailty in haemodialysis recipients is not known. This study explores the relationship between ultrasound-derived bilateral anterior thigh thickness (BATT), sarcopenia, and frailty by common frailty tools (Frailty Phenotype [FP], Frailty Index [FI], Edmonton Frailty [EFS], and Clinical Frailty Scale [CFS]).
Methods
This was an exploratory analysis of a subgroup of adult prevalent (≥3 months) haemodialysis recipients deeply phenotyped for frailty. Ultrasound assessment of BATT was obtained with participants at an angle of ≤45°, with legs outstretched and knees resting at 10°-20°, according to an established protocol. Associations with frailty were explored via both linear and logistic regressions for BATT, Low Muscle Mass (LMM), and sarcopenia with stepwise adjustment for a priori covariables.
Results
In total 223 study participants had ultrasound measurements. Frailty ranged from 34% for FP to 58% for FI. BATT was associated with increasing frailty on simple linear regression by all frailty tools, but lost significance on addition of covariables. Upon dichotomising frailty tools into Frail/Not Frail, BATT was associated with frailty by all tools on univariable analyses, but only retained association for EFS on the fully adjusted model (OR 0.97, 95% C.I. 0.94–1.00, P = 0.05).
Conclusions
Ultrasound measures of quadriceps thickness is variably associated with frailty in prevalent haemodialysis recipients, dependent upon the frailty tool used, but not independent of other variables. Further work is required to establish the added value of sarcopenia measurement in frail haemodialysis patients.
Authors: Benjamin M Anderson Daisy V Wilson, Muhammad Qasim Gonzalo Correa, Felicity Evison Suzy Gallier Charles J Ferro Thomas A Jackson Adnan Sharif
