Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis

Background We examined the association between computed tomography (CT)-derived paraspinous muscle density (PSMD) and index (PSMI) and all-cause mortality in patients undergoing hemodialysis.Methods We included 234 hemodialysis patients and used CT images to measure PSMD and PSMI at the third lumbar...

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Main Authors: Takahiro Yajima, Kumiko Yajima
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2520908
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author Takahiro Yajima
Kumiko Yajima
author_facet Takahiro Yajima
Kumiko Yajima
author_sort Takahiro Yajima
collection DOAJ
description Background We examined the association between computed tomography (CT)-derived paraspinous muscle density (PSMD) and index (PSMI) and all-cause mortality in patients undergoing hemodialysis.Methods We included 234 hemodialysis patients and used CT images to measure PSMD and PSMI at the third lumbar vertebra level. PSMD and PSMI were determined as the average CT-based value of the paraspinous muscle in Hounsfield units (HUs) and as the paraspinous muscle area adjusted by height (cm2/m2), respectively. We used univariate and multivariate regression analysis to investigate the associations of PSMD and PSMI with baseline variables. Moreover, we used the Kaplan-Meier methods, Cox regression analysis, and prediction model discrimination to examine the relationships of these paraspinous sarcopenic indices with mortality risk.Results The PSMD and PSMI were independently associated with the C-reactive protein level and geriatric nutritional risk index, respectively. The receiver operating curve-derived sex-specific cutoffs of PSMD and PSMI for predicting mortality were 32.1 HU and 13.29 cm2/m2 in women, and 38.4 HU and 14.97 cm2/m2 in men, respectively. Eighty-one patients died during a median follow-up period of 4.0 years. Lower PSMD alone was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio [aHR]: 3.14, 95% confidence interval [CI]: 1.81–5.46). In addition, only when PSMD was added to the baseline risk model, the net reclassification improvement significantly improved (0.516, p = 0.0001).Conclusions PSMD may be better than PSMI for predicting all-cause mortality risk in patients undergoing hemodialysis.
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spelling doaj-art-8baae87a2a5042fdb2b4b4047a2ae3932025-08-20T02:10:27ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2520908Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysisTakahiro Yajima0Kumiko Yajima1Department of Nephrology, Matsunami General Hospital, Gifu, JapanDepartment of Internal Medicine, Matsunami General Hospital, Gifu, JapanBackground We examined the association between computed tomography (CT)-derived paraspinous muscle density (PSMD) and index (PSMI) and all-cause mortality in patients undergoing hemodialysis.Methods We included 234 hemodialysis patients and used CT images to measure PSMD and PSMI at the third lumbar vertebra level. PSMD and PSMI were determined as the average CT-based value of the paraspinous muscle in Hounsfield units (HUs) and as the paraspinous muscle area adjusted by height (cm2/m2), respectively. We used univariate and multivariate regression analysis to investigate the associations of PSMD and PSMI with baseline variables. Moreover, we used the Kaplan-Meier methods, Cox regression analysis, and prediction model discrimination to examine the relationships of these paraspinous sarcopenic indices with mortality risk.Results The PSMD and PSMI were independently associated with the C-reactive protein level and geriatric nutritional risk index, respectively. The receiver operating curve-derived sex-specific cutoffs of PSMD and PSMI for predicting mortality were 32.1 HU and 13.29 cm2/m2 in women, and 38.4 HU and 14.97 cm2/m2 in men, respectively. Eighty-one patients died during a median follow-up period of 4.0 years. Lower PSMD alone was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio [aHR]: 3.14, 95% confidence interval [CI]: 1.81–5.46). In addition, only when PSMD was added to the baseline risk model, the net reclassification improvement significantly improved (0.516, p = 0.0001).Conclusions PSMD may be better than PSMI for predicting all-cause mortality risk in patients undergoing hemodialysis.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2520908Computed tomographyhemodialysisparaspinous muscle densityparaspinous muscle indexparaspinous muscle sarcopenic indices
spellingShingle Takahiro Yajima
Kumiko Yajima
Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis
Renal Failure
Computed tomography
hemodialysis
paraspinous muscle density
paraspinous muscle index
paraspinous muscle sarcopenic indices
title Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis
title_full Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis
title_fullStr Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis
title_full_unstemmed Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis
title_short Paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis
title_sort paraspinous muscle sarcopenic indices for predicting mortality in patients undergoing hemodialysis
topic Computed tomography
hemodialysis
paraspinous muscle density
paraspinous muscle index
paraspinous muscle sarcopenic indices
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2520908
work_keys_str_mv AT takahiroyajima paraspinousmusclesarcopenicindicesforpredictingmortalityinpatientsundergoinghemodialysis
AT kumikoyajima paraspinousmusclesarcopenicindicesforpredictingmortalityinpatientsundergoinghemodialysis