Association between muscle strength and echogenicity using greyscale ultrasound software : a diagnostic accuracy study in kidney transplant candidates
Acuña-Pardo, Carolina (Institut Hospital del Mar d'Investigacions Mèdiques)
Muñoz-Redondo, Elena (Institut Hospital del Mar d'Investigacions Mèdiques)
Delcros-Forestier, Lou (Institut Hospital del Mar d'Investigacions Mèdiques)
Curbelo P, Yulibeth G. (Hospital del Mar (Barcelona, Catalunya))
Rodríguez-Hernández, Carlos (Hospital del Mar (Barcelona, Catalunya))
Meza-Valderrama, Delky (Institut Hospital del Mar d'Investigacions Mèdiques)
Sánchez-Rodríguez, Dolores (Institut Hospital del Mar d'Investigacions Mèdiques)
Pascual, Julio (Institut Hospital del Mar d'Investigacions Mèdiques)
Pérez-Sáez, Maria J (Institut Hospital del Mar d'Investigacions Mèdiques)
Marco, Ester (Institut Hospital del Mar d'Investigacions Mèdiques)

Data:	2025
Resum:	BACKGROUND: Advanced chronic kidney disease disrupts the delicate equilibrium between protein anabolism and catabolism, leading to alterations in muscle quantity, quality, and function. Musculoskeletal ultrasound emerges as a promising assessment tool due to its widespread availability and high reliability. AIM: To evaluate the efficacy of rectus femoris (RF) echogenicity, measured using greyscale software, in identifying diminished muscle quality and strength in candidates for kidney transplant. DESIGN: Post-hoc diagnostic accuracy study. SETTING: Outpatients in a multimodal prehabilitation program pre kidney transplantation (KT). POPULATION: Patients on the waiting list for KT. METHODS: Sensitivity, specificity, likelihood ratios and area under the curve (AUC) for diagnostic efficacy of echogenicity (index test) assessed with the ImageJ software greyscale as a potential marker of quadriceps muscle weakness (reference test) were calculated. Muscle weakness was considered as maximal voluntary isometric contraction of the quadriceps (Q-MVIC) <40% of body weight. Other variables included body composition parameters derived from multifrequency electrical bioimpedance, upper limb muscle strength (handgrip), and RF thickness assessed by ultrasound. Statistical tests: Chi-square, t-Student, Pearson correlation coefficients (r), bivariate and multivariate logistic regression models. Statistical significance level ≤0. 05. RESULTS: Of 112 patients (mean age: 63. 6, 76% male), 72 (63. 7%) exhibited quadriceps weakness, while 80 (70. 8%) had some degree of overhydration (extracellular water/total body water ratio >0. 390). The echogenicity cut-off point of highest concordance with muscle weakness was 70, boasting a sensitivity of 83%, specificity of 57%, and AUC of 0. 671 (CI 95% 0. 570-0. 772 [P=0. 003]). Echogenicity >70 was associated with a 3. 4-fold higher risk of muscle weakness (crude OR = 3. 4 [CI95% 1. 4 to 8. 0]), which persisted after adjusting for age, height, weight and RF thickness. CONCLUSIONS: The RF echogenicity exhibits fair validity in identifying muscle weakness among candidates for KT. However, it cannot be endorsed as a standalone diagnostic tool in this population.
Ajuts:	Instituto de Salud Carlos III PI19/00037
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Muscles ; Ultrasonography ; Muscle strength ; Kidney transplantation
Publicat a:	European Journal of Physical and Rehabilitation Medicine, Vol. 61 Núm. 1 (February 2025) , p. 119-129, ISSN 1973-9095

DOI: 10.23736/S1973-9087.24.08496-X
PMID: 39679795

11 p, 1.6 MB

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