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

Background: Sarcopenia 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. Methods: Eleven 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. Results: Six patients exhibited low muscle volume (muscle volume z-score 75 th 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). Conclusions: The 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.