Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2026
Ultrasound-derived quadriceps muscle measurements are independently associated with physical frailty in patients undergoing hemodialysis.
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Manuella de Moraes Zacarias Ester, Batista Ferro Camila Moura, Vogado Rodrigues Roseane Maria, Oliveira Pacheco André Luís, Horst Maria Aderuza, Prado Carla M, Neves Rodrigues Hellen Christina, Costa Nara Aline
Аннотация
OBJECTIVE: Patients undergoing hemodialysis (HD) frequently experience functional decline and a high prevalence of physical frailty. Ultrasound-derived muscle assessment enables objective bedside quantification of muscle mass and composition, while circulating biomarkers may provide additional insight into muscle-related physiology. This study examined the association of quadriceps muscle ultrasound measurements and serum biomarkers with physical frailty in HD patients.
DESIGN AND METHODS: This is a subanalysis of a cohort study comprising adult patients on maintenance HD. Physical frailty was classified using the Physical Frailty Phenotype (≥ 3 criteria). Blood samples were collected to measure serum concentrations of heat shock protein 72 (HSP72) and C-terminal agrin fragment (CAF) using ELISA kits. After the HD session, B-mode ultrasound was performed to assess thickness and echogenicity of the rectus femoris and vastus intermedius (RFVI), and vastus lateralis and vastus intermedius (VLVI).
RESULTS: Seventy-six patients were included, 45% with frailty. Multivariate logistic regression model adjusted for body mass index, age, and HD vintage, greater muscle thickness was associated with lower odds of frailty [RFVI (OR: 0.340; 95%CI: 0.150-0.774; p = 0.010); VLVI (OR: 0.244; 95% CI: 0.093-0.642; p = 0.004)], while higher muscle echogenicity was associated with higher odds [(RFVI (OR: 1.048; 95% CI: 1.007-1.090; p = 0.021); VLVI (OR: 1.108; 95% CI: 1.043-1.176; p = 0.001). No significant associations were found between CAF and Hsp72 with frailty.
CONCLUSION: Quadriceps muscle measurements were associated with physical frailty, reinforcing their use as a practical and clinically relevant tool for muscle assessment in hemodialysis patients.
DESIGN AND METHODS: This is a subanalysis of a cohort study comprising adult patients on maintenance HD. Physical frailty was classified using the Physical Frailty Phenotype (≥ 3 criteria). Blood samples were collected to measure serum concentrations of heat shock protein 72 (HSP72) and C-terminal agrin fragment (CAF) using ELISA kits. After the HD session, B-mode ultrasound was performed to assess thickness and echogenicity of the rectus femoris and vastus intermedius (RFVI), and vastus lateralis and vastus intermedius (VLVI).
RESULTS: Seventy-six patients were included, 45% with frailty. Multivariate logistic regression model adjusted for body mass index, age, and HD vintage, greater muscle thickness was associated with lower odds of frailty [RFVI (OR: 0.340; 95%CI: 0.150-0.774; p = 0.010); VLVI (OR: 0.244; 95% CI: 0.093-0.642; p = 0.004)], while higher muscle echogenicity was associated with higher odds [(RFVI (OR: 1.048; 95% CI: 1.007-1.090; p = 0.021); VLVI (OR: 1.108; 95% CI: 1.043-1.176; p = 0.001). No significant associations were found between CAF and Hsp72 with frailty.
CONCLUSION: Quadriceps muscle measurements were associated with physical frailty, reinforcing their use as a practical and clinically relevant tool for muscle assessment in hemodialysis patients.