Validity of Ultrasound Imaging in Measuring Quadriceps Muscle Thickness and Cross-Sectional Area in Patients Receiving Maintenance Hemodialysis.

Muscle wasting, prevalent in maintenance hemodialysis (HD) patients diagnosed with protein-energy wasting, represents an assessment challenge in the outpatient HD setting. Quadriceps muscle thickness (QMT) and cross-sectional area (CSA) assessment by ultrasound (US) is a potential surrogate measure for muscle wasting. We aimed to determine the validity of US to measure QMT and CSA against the gold standard-computed tomography (CT). Twenty-six patients on HD underwent US and CT scans on the same day, postdialysis session. QMT for rectus femoris (RF) and vastus intermedius (VI) muscles was taken at the midpoint (MID) and two-thirds (2/3) of both thighs and CSA of the RF muscle (RFCSA ), respectively. Correlation between US and CT measurements was determined by intraclass correlation coefficient (ICC) and Bland-Altman plot. ICC (95% CI) computed between US and CT was 0.94 (0.87-0.97), 0.97 (0.93-0.99), 0.94 (0.87-0.97), 0.94 (0.86-0.97), and 0.92 (0.83-0.97) for RFMID , VIMID, RF2/3, VI2/3 , and RFCSA , respectively (all P < 0.001). Bland-Altman analysis indicated no bias in agreement between both methods. The US imaging offers a valid and quick bedside assessment approach to assess muscle wasting in HD patients. © 2020 American Society for Parenteral and Enteral Nutrition.

Citation

Sharmela Sahathevan, Ban-Hock Khor, Chai Hong Yeong, Teik Hin Tan, Abdul Kareem Meera Mohaideen, Hi Ming Ng, Gild Rick Ong, Sreelakshmi Sankara Narayanan, Abdul Halim Abdul Gafor, Bak Leong Goh, Boon Cheak Bee, Zulfitri 'Azuan Mat Daud, Karuthan Chinna, Tilakavati Karupaiah. Validity of Ultrasound Imaging in Measuring Quadriceps Muscle Thickness and Cross-Sectional Area in Patients Receiving Maintenance Hemodialysis. JPEN. Journal of parenteral and enteral nutrition. 2021 Feb;45(2):422-426

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PMID: 32384179

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