Psoas Muscle Area as a Measure for Sarcopenia and a Predictor of Poor Health Outcomes in Chronic Kidney Disease
Bibliographic record
Abstract
Background: Sarcopenia ofen presents in parallel with chronic kidney disease (CKD), associated with a decondi<oned state, chronic inflamma<on, and poor nutri<onal status.Psoas muscle area (PMA) measurements have been previously associated with mortality in CKD however, whether PMA can be useful in predic<ng other clinical outcomes such as hospitaliza<ons, infec<ons and other health events are less established.ObjecFve: The primary objec<ve of this study is to report the associa<on of PMA with hospitaliza<ons, hemodialysis, mortality, and infec<ons in pa<ents with CKD.Methods: A retrospec<ve non-matched cohort study was conducted in a community nephrology clinic in Quebec, Canada, and included laboratory, radiological, and demographic data collected from April 1, 2015, un<l December 31, 2021.PMA was measured by two independent readers using the DICOM RADiant Viewer Sofware. Main Findings:A total of 269 clinic charts were reviewed and included.Subjects had a median age of 74 years (IQR 31-92) with 58.3% reported as male.The prevalence of Grade 1 and 2, Grade 3, Grade 4 and Grade 5 CKD was 3%, 53%, 32%, and 10%.Median follow-up <me was 1160 days .Median measurement of PMA/height was 3.53 cm 2 /m (0.5-8.73).Sta<s<cally significant concurrent rela<onships were documented between PMA and event-free <me for dialysis and hospitaliza<on.The adjusted HR for PMA < 2.66 cm 2 /m are 0.39 (95% CI 0.16-0.94),p=0.0356.For hospital-free <me, the adjusted HR for PMA quar<les showed a dose-dependent increase in effect size, with PMA about a 2-fold higher hazard risk ra<o seen for a longer hospital admission-free period, (p=0.0273).The Cox hazard propor<onal mul<variate analyses documented the concurrently nega<ve rela<onships between PMA and length of survival and infec<on-free <me, reaching a trend towards significance.For length of survival, PMA < 2.1 cm 2 /m had an adjusted Hazard risk reduc<on of 82 % (HR 0.18 (95%CI 0.024-1.38))and similarly for infec<on-free <me un<l the first event, the adjusted HR for PMA < 2 cm 2 /m are 0.38 (95% CI 0.17-1.0).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".