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  11. Acute Skeletal Muscle Wasting In Patients With Acute Kidney Injury Requiring Continuous Kidney Replacement Therapy: A Prospective Multicenter Study

Acute skeletal muscle wasting in patients with acute kidney injury requiring continuous kidney replacement therapy: A prospective multicenter study

Kirby P Mayer1, J Pedro Teixeira2, Felipe González-Seguel3

  • 1Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.

Journal of Critical Care
|June 13, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Critically ill patients with acute kidney injury (AKI) requiring continuous kidney replacement therapy (CKRT) experienced significant muscle wasting within the first week of treatment. A high percentage of survivors developed intensive care unit-associated weakness (ICU-AW) by hospital discharge.

Keywords:
Acute kidney injuryContinuous kidney replacement therapyDialysisICU-acquired weakness

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Physical Therapy

Background:

  • Acute kidney injury (AKI) is common in critically ill patients.
  • Continuous kidney replacement therapy (CKRT) is often required for AKI management.
  • The impact of CKRT on muscle health and ICU-associated weakness (ICU-AW) is not well-established.

Purpose of the Study:

  • To prospectively evaluate muscle mass and quality changes in critically ill adults with AKI undergoing CKRT.
  • To determine the incidence of ICU-associated weakness (ICU-AW) at hospital discharge in this patient population.

Main Methods:

  • Prospective observational study at two academic hospitals.
  • Critically ill adults with AKI requiring CKRT were enrolled.
  • Rectus femoris muscle mass and quality were assessed using ultrasonography (US) in the first week of CKRT.
  • ICU-AW, physical function, and frailty were evaluated at hospital discharge.

Main Results:

  • Twenty-three patients were enrolled; median age 56 years, BMI 29 kg/m², Charlson Comorbidity Index 3.
  • Significant muscle wasting occurred within the first week of CKRT: rectus femoris muscle thickness decreased by 10%, cross-sectional area by 19%, and echo intensity (quality) increased by 14%.
  • 67% of survivors (10/15) met criteria for ICU-AW at hospital discharge.

Conclusions:

  • Patients with AKI requiring CKRT experience substantial muscle wasting early in their treatment.
  • High rates of ICU-associated weakness are observed in survivors of AKI treated with CKRT.
Muscle weakness
Physical frailty
Physical function