Abstract
BackgroundChronic kidney disease (CKD) is a catabolic condition associated with muscle wasting and dysfunction, which associates with morbidity and mortality. There is a need for simple techniques capable of monitoring changes in muscle size with disease progression and in response to interventions aiming to increase muscle mass and function. Ultrasound is one such technique; however, it is unknown how well changes in muscle cross‐sectional area (CSA) measured using ultrasound relate to changes in whole muscle volume measured using magnetic resonance imaging. We tested whether rectus femoris CSA (RF‐CSA) could be used as a valid indication of changes in quadriceps muscle volume as a single measure of muscle size and following a 12 week exercise intervention that resulted in muscle hypertrophy.MethodsSecondary analysis of data was collected from the ExTra CKD study (ISRCTN 36489137). Quadriceps muscle size was assessed from 36 patients with non‐dialysis CKD before and after 12 weeks of supervised exercise that resulted in muscle hypertrophy.ResultsStrong positive correlations were observed between RF‐CSA and quadriceps volume at baseline (r 2 = 0.815, CI 0.661 to 0.903; P < 0.001) and following 12 week exercise (r 2 = 0.845, CI 0.700 to 0.923; P < 0.001). A moderate positive association was also observed between changes in RF‐CSA and quadriceps following exercise training (rho = 0.441, CI 0.085 to 0.697; P = 0.015). Bland–Altman analysis revealed a small bias (bias 0.6% ± 12.5) between the mean percentage changes in RF‐CSA and quadriceps volume but wide limits of agreement from −24 to 25.ConclusionsRectus femoris CSA appears to be a reliable index of total quadriceps volume as a simple measure of muscle size, both as a single observation and in response to exercise training in non‐dialysis CKD patients.
Highlights
Chronic kidney disease (CKD) is a global health problem estimated to affect 8–16% of the population worldwide[1] and is associated with increased morbidity and mortality.[2]
We have shown that ultrasound-derived rectus femoris (RF)-cross-sectional area (CSA) is associated with physical performance amongst patients with CKD stages 3b–5 not requiring dialysis.[21]
We aimed to (i) investigate the association between a rectus femoris CSA (RF-CSA) assessed using ultrasound and total quadriceps volume measured by the gold standard magnetic resonance imaging (MRI) before and (ii) investigate comparisons between ultrasound and MRI in response to a 12 week exercise intervention that resulted in increased muscle size and volume.[22]
Summary
Chronic kidney disease (CKD) is a global health problem estimated to affect 8–16% of the population worldwide[1] and is associated with increased morbidity and mortality.[2]. Current guidelines for the screening of muscle wasting focus on the use of advance imaging techniques such as dual-energy Xray absorptiometry, magnetic resonance imaging (MRI), and computed tomography. The application of these methods in kidney disease populations has recently been extensively reviewed .12. There is a need for simple techniques capable of monitoring changes in muscle size with disease progression and in response to interventions aiming to increase muscle mass and function. Ultrasound is one such technique; it is unknown how well changes in muscle cross-sectional area (CSA) measured using ultrasound relate to changes in whole muscle volume measured using magnetic resonance imaging. We tested whether rectus femoris CSA (RF-CSA) could be used as a valid indication of changes in quadriceps muscle volume as a single measure of muscle size and following a 12 week exercise intervention that resulted in muscle hypertrophy
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