Predicting Sarcopenia in Peritoneal Dialysis Patients: A Multimodal Ultrasound-Based Logistic Regression Analysis and...

Area of Science:

• Nephrology
• Geriatrics
• Diagnostic Imaging

Background:

• Sarcopenia is a common complication in patients undergoing peritoneal dialysis (PD).
• Early detection of sarcopenia is crucial for managing PD patients and improving their quality of life.
• Current diagnostic methods may have limitations in accessibility and invasiveness.

Purpose of the Study:

• To evaluate the diagnostic value of logistic regression and nomogram models based on multimodal ultrasound for predicting sarcopenia in PD patients.
• To develop and validate a non-invasive prediction tool for sarcopenia in this population.

Main Methods:

• 178 PD patients were enrolled and categorized into sarcopenia and non-sarcopenia groups based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria.
• Multimodal ultrasound parameters (muscle thickness, pinna angle, fascicle length, attenuation coefficient, echo intensity) of the gastrocnemius medial head were measured.
• Binary logistic regression and nomogram models were constructed, and their accuracy was assessed using Receiver Operating Characteristic (ROC) curves.

Main Results:

• Patients with sarcopenia showed significantly lower muscle thickness, pinna angle, and fascicle length, and higher attenuation coefficient and echo intensity compared to non-sarcopenia patients (p < 0.05).
• A multimodal ultrasound logistic regression model achieved an F1-score of 0.785 and an Area Under the ROC Curve (ROC-AUC) of 0.902.
• The nomogram showed no statistical difference compared to appendicular skeletal muscle index (ASMI) measured by bioelectrical impedance analysis (BIA).

Conclusions:

• The developed multimodal ultrasound prediction model is effective in identifying PD patients at high risk of sarcopenia.
• This non-invasive tool can aid clinicians in early detection and intervention, potentially improving clinical outcomes.
• Ultrasound-based assessment offers a promising alternative for sarcopenia screening in PD patients.