Mid-arm muscle circumference and quality of life and survival in maintenance hemodialysis patients

Nazanin Noori, Joel D. Kopple, Csaba Kovesdy, Usama Feroze, John J. Sim, Sameer B. Murali, Amanda Luna, Myra Gomez, Claudia Luna, Rachelle Bross, Allen R. Nissenson, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

169 Citations (Scopus)

Abstract

Background and objectives: Maintenance hemodialysis (MHD) patients with larger body or fat mass have greater survival than normal to low mass. We hypothesized that mid-arm muscle circumference (MAMC), a conveniently measured surrogate of lean body mass (LBM), has stronger association with clinical outcomes than triceps skinfold (TSF), a surrogate of fat mass. Design, settings, participants, & measurements: The associations of TSF, MAMC, and serum creatinine, another LBM surrogate, with baseline short form 36 quality-of-life scores and 5-year survival were examined in 792 MHD patients. In a randomly selected subsample of 118 subjects, LBM was measured by dual-energy x-ray absorptiometry. Results: Dual-energy x-ray absorptiometry-assessed LBM correlated most strongly with MAMC and serum creatinine. Higher MAMC was associated with better short form 36 mental health scale and lower death hazard ratios (HRs) after adjustment for case-mix, malnutrition-inflammation-cachexia syndrome, and inflammatory markers. Adjusted death HRs were 1.00, 0.86, 0.69, and 0.63 for the first to fourth MAMC quartiles, respectively. Higher serum creatinine and TSF were also associated with lower death HRs, but these associations were mitigated after multivariate adjustments. Using median values of TSF and MAMC to dichotomize, combined high MAMC with either high or low TSF (compared with low MAMC/TSF) exhibited the greatest survival, i.e., death HRs of 0.52 and 0.59, respectively. Conclusions: Higher MAMC is a surrogate of larger LBM and an independent predictor of better mental health and greater survival in MHD patients. Sarcopenia-correcting interventions to improve clinical outcomes in this patient population warrant controlled trials.

Original languageEnglish (US)
Pages (from-to)2258-2268
Number of pages11
JournalClinical Journal of the American Society of Nephrology
Volume5
Issue number12
DOIs
StatePublished - Dec 1 2010

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Renal Dialysis
Maintenance
Quality of Life
Muscles
Survival
Creatinine
Mental Health
Serum
Fats
X-Rays
Sarcopenia
Risk Adjustment
Social Adjustment
Cachexia
Malnutrition
Inflammation
Population

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Mid-arm muscle circumference and quality of life and survival in maintenance hemodialysis patients. / Noori, Nazanin; Kopple, Joel D.; Kovesdy, Csaba; Feroze, Usama; Sim, John J.; Murali, Sameer B.; Luna, Amanda; Gomez, Myra; Luna, Claudia; Bross, Rachelle; Nissenson, Allen R.; Kalantar-Zadeh, Kamyar.

In: Clinical Journal of the American Society of Nephrology, Vol. 5, No. 12, 01.12.2010, p. 2258-2268.

Research output: Contribution to journalArticle

Noori, N, Kopple, JD, Kovesdy, C, Feroze, U, Sim, JJ, Murali, SB, Luna, A, Gomez, M, Luna, C, Bross, R, Nissenson, AR & Kalantar-Zadeh, K 2010, 'Mid-arm muscle circumference and quality of life and survival in maintenance hemodialysis patients', Clinical Journal of the American Society of Nephrology, vol. 5, no. 12, pp. 2258-2268. https://doi.org/10.2215/CJN.02080310
Noori, Nazanin ; Kopple, Joel D. ; Kovesdy, Csaba ; Feroze, Usama ; Sim, John J. ; Murali, Sameer B. ; Luna, Amanda ; Gomez, Myra ; Luna, Claudia ; Bross, Rachelle ; Nissenson, Allen R. ; Kalantar-Zadeh, Kamyar. / Mid-arm muscle circumference and quality of life and survival in maintenance hemodialysis patients. In: Clinical Journal of the American Society of Nephrology. 2010 ; Vol. 5, No. 12. pp. 2258-2268.
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AU - Noori, Nazanin

AU - Kopple, Joel D.

AU - Kovesdy, Csaba

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AU - Sim, John J.

AU - Murali, Sameer B.

AU - Luna, Amanda

AU - Gomez, Myra

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AU - Bross, Rachelle

AU - Nissenson, Allen R.

AU - Kalantar-Zadeh, Kamyar

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