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Clinical Trial
. 2023 Jan 18;24(1):16.
doi: 10.1186/s12882-022-03043-8.

Ultrasound quadriceps muscle thickness is variably associated with frailty in haemodialysis recipients

Benjamin M Anderson  1   2 , Daisy V Wilson  2   3 , Muhammad Qasim  1   4 , Gonzalo Correa  5 , Felicity Evison  6 , Suzy Gallier  6   7 , Charles J Ferro  1   8 , Thomas A Jackson  2   3 , Adnan Sharif  9   10
Affiliations
Clinical Trial

Ultrasound quadriceps muscle thickness is variably associated with frailty in haemodialysis recipients

Benjamin M Anderson et al. BMC Nephrol. .

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.

Trial registration: Clinicaltrials.gov : NCT03071107 registered 06/03/2017.

Keywords: Epidemiology; Frailty; Sarcopenia; Ultrasound.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of FITNESS study participation
Fig. 2
Fig. 2
Composite of simple and multiple linear regression models of association between BATT, Low Muscle Mass, and Sarcopenia with Frailty
Fig. 3
Fig. 3
Composite of univariable and multivariable logistic regression models of association between BATT, Low Muscle Mass, and Sarcopenia with Frailty
See this image and copyright information in PMC

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