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Abstract
This study examined the effects of muscle mass on mortality in patients with acute kidney injury requiring continuous renal replacement therapy. It was conducted in eight medical centers between 2006 and 2021. The data of 2200 patients over the age of 18 years with acute kidney injury who required continuous renal replacement therapy were retrospectively collected. Skeletal muscle areas, categorized into normal and low attenuation muscle areas, were obtained from computed tomography images at the level of the third lumbar vertebra. Cox proportional hazards models were used to investigate the association between mortality within 1, 3, and 30 days and skeletal muscle index. Sixty percent of patients were male, and the 30-day mortality rate was 52%. Increased skeletal muscle areas/body mass index was associated with decreased mortality risk. We also identified a 26% decreased risk of low attenuation muscle area/body mass index on mortality. We established that muscle mass had protective effects on the mortality of patients with acute kidney injury requiring continuous renal replacement therapy. This study showed that muscle mass is a significant determinant of mortality, even if the density is low.
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1 Dongguk University Ilsan Hospital, Clinical Trial Center, Goyang, South Korea (GRID:grid.470090.a) (ISNI:0000 0004 1792 3864); Dongguk University College of Medicine, Research Center for Chronic Disease and Environmental Medicine, Gyeongju, South Korea (GRID:grid.255168.d) (ISNI:0000 0001 0671 5021)
2 Dongguk University College of Medicine, Research Center for Chronic Disease and Environmental Medicine, Gyeongju, South Korea (GRID:grid.255168.d) (ISNI:0000 0001 0671 5021); Dongguk University Ilsan Hospital, Department of Internal Medicine, Goyang, South Korea (GRID:grid.470090.a) (ISNI:0000 0004 1792 3864)
3 Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Department of Internal Medicine, Daegu, South Korea (GRID:grid.258803.4) (ISNI:0000 0001 0661 1556)
4 Seoul National University Hospital, Department of Internal Medicine, Seoul, South Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X)
5 The Catholic University of Korea, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, Seoul, South Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224)
6 Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Department of Internal Medicine, Daegu, South Korea (GRID:grid.412091.f) (ISNI:0000 0001 0669 3109)
7 Daejeon Eulji Medical Center, Eulji University, Department of Internal Medicine, Daejeon, South Korea (GRID:grid.255588.7) (ISNI:0000 0004 1798 4296)
8 Inha University Hospital, Inha University College of Medicine, Department of Internal Medicine, Incheon, South Korea (GRID:grid.255588.7)
9 Uijeongbu Eulji Medical Center, Eulji University, Department of Internal Medicine, Gyeonggi-Do, South Korea (GRID:grid.255588.7) (ISNI:0000 0004 1798 4296)
10 Dongguk University College of Medicine, Research Center for Chronic Disease and Environmental Medicine, Gyeongju, South Korea (GRID:grid.255168.d) (ISNI:0000 0001 0671 5021); Dongguk University Ilsan Hospital, Department of Internal Medicine, Goyang, South Korea (GRID:grid.470090.a) (ISNI:0000 0004 1792 3864); Dongguk University College of Medicine, Department of Internal Medicine, Gyeongju, South Korea (GRID:grid.255168.d) (ISNI:0000 0001 0671 5021)
11 Asan Institute for Life Sciences, Asan Medical Center, Biomedical Research Center, Seoul, South Korea (GRID:grid.413967.e) (ISNI:0000 0001 0842 2126)
12 Asan Medical Center, University of Ulsan College of Medicine, Department of Radiology, Seoul, South Korea (GRID:grid.413967.e) (ISNI:0000 0001 0842 2126)
13 Asan Medical Center, University of Ulsan College of Medicine, Division of Nephrology, Department of Internal Medicine, Seoul, South Korea (GRID:grid.413967.e) (ISNI:0000 0001 0842 2126)