Impact of Sarcopenia on Renal Outcomes in Patients with Septic Acute Kidney Injury: A Retrospective Cohort Study

Abstract

Purpose: Despite the high prevalence of sarcopenia and the significant burden of septic acute kidney injury (AKI), the impact of sarcopenia on renal outcomes in patients with septic AKI has not been studied. Therefore, we aimed to evaluate the effect of sarcopenia on the renal prognosis of patients with septic AKI. Materials and Methods: This retrospective study enrolled patients with septic AKI between July 2008 and March 2019. Sarcopenia was identified by measuring the total abdominal muscle area using abdominal CT. Patients were divided into sarcopenia and non-sarcopenia groups. The effect of sarcopenia on 90-day renal outcomes, including a >50% decrease in the estimated glomerular filtration rate, dialysis dependence, and requirement for continuous renal replacement therapy within 90 days, was analysed. Additionally, the effect of sarcopenia on 90-day mortality was assessed. Results: Of the 608 enrolled patients with septic AKI, 273 (44.9%) were assigned to the sarcopenia group. At baseline, there were no significant differences in the severity score and distribution of AKI stages between the two groups. There was no significant between-group difference in the 90-day renal outcomes. Moreover, sarcopenia was not associated with 90-day renal outcomes across all AKI stages in stratified multivariable logistic analysis. In contrast, the 90-day mortality rates were significantly higher in the sarcopenia group than in the non-sarcopenia group (30.0% vs. 17.3%, respectively; p<0.001). Conclusion: Sarcopenia was significantly associated with an increased 90-day mortality rate; however, no significant association with 90-day renal progression was observed in patients with septic AKI.