Validation of Ultrasound Measurement of Vastus Lateralis for Appendicular Skeletal Muscle Mass in Chronic Kidney Disease Patients with Hemodialysis

Abstract

Background: Chronic kidney disease patients undergoing hemodialysis (HD) are at a high risk of developing sarcopenia. This study aimed to validate the performance of ultrasound (US) measurements of the vastus lateralis (VL) for estimating muscle mass and diagnosing sarcopenia in CKD patients with HD. Methods: Forty-six patients were enrolled in this study. Muscle thickness (MT) and echo intensity (EI) of VL, physical performance, and biochemical markers were collected to establish a linear regression model for predicting appendicular skeletal muscle mass (ASM), using dual-energy X-ray absorptiometry (DXA) as the reference standard. The model’s performance was validated, and its diagnostic accuracy for sarcopenia was also evaluated. Results: An ASM prediction model was derived: −20.17 + 1.90 × MT_VL (cm) + 1.58 × male + 0.16 × Height (cm) + 0.09 × Weight (kg) + 0.05 × Age (year), with a standard estimated error of 1.44 kg and adjusted R-squared of 0.84. The model exhibited high correlation and an acceptable limit of agreement, compared to DXA measurement. EI displayed a negative correlation with ASM and MT. Conclusions: The ASM adjusted with BMI demonstrated superior performance in diagnosing sarcopenia compared to the ASM adjusted with height. Ultrasound provides a cost-effective bedside tool for evaluating muscle conditions in HD patients.

Keywords

• muscle thickness
• muscle mass
• echo intensity
• sarcopenia
• ultrasound