# Prognostic Significance of Baseline Lean Tissue Mass Percentage in Incident Peritoneal Dialysis Patients

## TL;DR

Measuring lean tissue mass in new peritoneal dialysis patients predicts better survival and fewer hospital issues, suggesting muscle mass monitoring could improve care.

## Contribution

This study demonstrates that baseline lean tissue mass percentage is a prognostic indicator in incident peritoneal dialysis patients.

## Key findings

- Higher baseline %LTM is associated with better 5-year patient survival rates.
- Baseline %LTM is inversely related to hospitalization rate and duration of hospital stay.
- Baseline %LTM is linked to peritonitis-free survival but not to technique survival or peritonitis rate.

## Abstract

Bioimpedance spectroscopy is a convenient method to measure lean tissue mass (LTM), which is commonly taken as the skeletal muscle mass, in peritoneal dialysis (PD) patients. We investigated the prognostic significance of LTM as the percentage of body weight (%LTM) and as the marker of sarcopenia in incident PD patients.

A retrospective review of a prospective cohort.

349 incident PD patients in a single center.

Baseline %LTM.

Patient survival, technique survival, peritonitis-free survival, peritonitis rate, hospitalization rate, and the duration of hospitalization.

Time-to-event survival analyses; linear regression for hospitalization.

The 5-year patient survival rates were 50.2%, 55.3%, 61.0%, and 72.6% for patients with %LTM quartiles I-IV, respectively (log-rank test; P = 0.02). Multivariable Cox regression analysis confirmed that baseline %LTM was associated with patient survival (adjusted HR, 0.982; 95% CI, 0.966-0.999; P = 0.04). Baseline %LTM was also associated with peritonitis-free survival (adjusted HR, 0.983; 95% CI, 0.968-0.998; P = 0.031), but not technique survival. %LTM was also significantly and inversely associated with the hospitalization rate (P = 0.002) and the duration of hospitalization (P = 0.02). Yet, %LTM was unrelated to the 5-year technique survival (P = 0.29) and the peritonitis rate (P = 0.15). The number of hospital admissions was 2.72, 2.39, 2.36, and 1.67 per year of follow-up for quartiles I-IV of baseline %LTM (Jonckheere-Terpstra test; P = 0.002), and the duration of hospital stay was 23.31, 20.84, 22.27, and 13.96 d/y, respectively (P = 0.02).

Observational study with baseline measures only.

Baseline %LTM as measured using bioimpedance spectroscopy is associated with patient survival, peritonitis-free survival, the number of hospital admissions, and the duration of hospital stay in incident PD patients.

Muscle wasting is a common problem in dialysis patients. In patients starting peritoneal dialysis, we measured their lean tissue mass using bioimpedance spectroscopy. We found that patients with higher percentages of lean tissue mass had better survival rates over 5 years, fewer and shorter hospital stays, and a lower risk of infection complications (peritonitis). Overall, measuring muscle mass in new peritoneal dialysis patients can help predict who is likely to do better with treatment and have fewer hospital problems, suggesting that monitoring and possibly improving muscle mass could be important for patient care.