Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica
Ano de defesa: | 2019 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de São Paulo (UNIFESP)
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Programa de Pós-Graduação: |
Não Informado pela instituição
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Departamento: |
Não Informado pela instituição
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País: |
Não Informado pela instituição
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Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Link de acesso: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7878075 https://repositorio.unifesp.br/handle/11600/59587 |
Resumo: | Background: In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the loss of skeletal muscle mass. Muscle mass is a key element for evaluation of nutritional disturbances, and low muscle mass is associated with increased morbidity and mortality. An accurate method for muscle mass evaluation that is not subject to errors caused by perturbations in the uremic milieu remains a challenge for the nephrology community. Methods: This is a prospective observational cohort study. We evaluated 223 non-dialyzed CKD patients [60.3±10.6 years; 64% men; 50% diabetics; glomerular filtration rate (GFR) 27.3±16.3 ml/min/1.73m2]. Muscle mass was measured by computed tomography at the third lumbar vertebra region (CTMM-L3) using the Slice-O-Matic software and analyzed according to percentile adjusted by gender. Nutritional parameters, laboratory data and comorbidities were evaluated, and mortality was followed-up for 4 years. Results: During the study period 63 patients died, and the main cause of death was cardiovascular disease. Patients who died were older, had lower GFR, hemoglobin and albumin, as well as lower muscle markers. CTMM-L3 below the 25th percentile was associated with higher mortality according to the Kaplan-Meier curve (P=0.017), and in Cox-regression analysis [crude hazard ratio, HR, 1.87 (95% confidence interval, CI, 1.11-3.16)], also when adjusting for potential confounders [HR 1.83 (CI 1.02-3.30)]. Conclusions: Low muscle mass measured by computed tomography at the third lumbar vertebra region is an independent predictor of increased mortality in non-dialyzed CKD patients. |
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Bichels, Andre Valente [UNIFESP]Universidade Federal de São Paulo (UNIFESP)http://lattes.cnpq.br/7254976533483796http://lattes.cnpq.br/3356377676492451http://lattes.cnpq.br/5874601346158886Kaneko, Maria Ayako Kamimura [UNIFESP]Silva Júnior, Antonio Carlos CordeiroSão Paulo2021-01-19T16:33:50Z2021-01-19T16:33:50Z2019-05-30https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7878075https://repositorio.unifesp.br/handle/11600/59587Background: In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the loss of skeletal muscle mass. Muscle mass is a key element for evaluation of nutritional disturbances, and low muscle mass is associated with increased morbidity and mortality. An accurate method for muscle mass evaluation that is not subject to errors caused by perturbations in the uremic milieu remains a challenge for the nephrology community. Methods: This is a prospective observational cohort study. We evaluated 223 non-dialyzed CKD patients [60.3±10.6 years; 64% men; 50% diabetics; glomerular filtration rate (GFR) 27.3±16.3 ml/min/1.73m2]. Muscle mass was measured by computed tomography at the third lumbar vertebra region (CTMM-L3) using the Slice-O-Matic software and analyzed according to percentile adjusted by gender. Nutritional parameters, laboratory data and comorbidities were evaluated, and mortality was followed-up for 4 years. Results: During the study period 63 patients died, and the main cause of death was cardiovascular disease. Patients who died were older, had lower GFR, hemoglobin and albumin, as well as lower muscle markers. CTMM-L3 below the 25th percentile was associated with higher mortality according to the Kaplan-Meier curve (P=0.017), and in Cox-regression analysis [crude hazard ratio, HR, 1.87 (95% confidence interval, CI, 1.11-3.16)], also when adjusting for potential confounders [HR 1.83 (CI 1.02-3.30)]. Conclusions: Low muscle mass measured by computed tomography at the third lumbar vertebra region is an independent predictor of increased mortality in non-dialyzed CKD patients.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação Oswaldo RamosFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Dados abertos - Sucupira - Teses e dissertações (2019)porUniversidade Federal de São Paulo (UNIFESP)Massa muscularTomografia computadorizadaComposição corporalDoença renal crônicaMortalidadeMuscle massComputed tomographyMortalityChronic kidney diseaseBody compositionAvaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônicaEvaluation of muscle mass measured by abdominal computed tomography as surrogate for mortality in nondialysis chronic kidney disease patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisMestradoinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPSão Paulo, Escola Paulista de MedicinaNutriçãoNutriçãoNutrição em Especialidades ClínicasORIGINALAndré Valente Bichels - A.pdfAndré Valente Bichels - A.pdfDissertação de mestradoapplication/pdf1730810${dspace.ui.url}/bitstream/11600/59587/1/Andr%c3%a9%20Valente%20Bichels%20-%20A.pdf8541e619cd16689d167252b922e7db2dMD51open access11600/595872023-09-29 12:01:54.086open accessoai:repositorio.unifesp.br:11600/59587Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-09-29T15:01:54Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.pt_BR.fl_str_mv |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica |
dc.title.alternative.en.fl_str_mv |
Evaluation of muscle mass measured by abdominal computed tomography as surrogate for mortality in nondialysis chronic kidney disease patients |
title |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica |
spellingShingle |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica Bichels, Andre Valente [UNIFESP] Massa muscular Tomografia computadorizada Composição corporal Doença renal crônica Mortalidade Muscle mass Computed tomography Mortality Chronic kidney disease Body composition |
title_short |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica |
title_full |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica |
title_fullStr |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica |
title_full_unstemmed |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica |
title_sort |
Avaliação da massa muscular medida pela tomografia computadorizada abdominal como preditor de morbidade e mortalidade em pacientes na fase não dialítica da doença renal crônica |
author |
Bichels, Andre Valente [UNIFESP] |
author_facet |
Bichels, Andre Valente [UNIFESP] |
author_role |
author |
dc.contributor.institution.pt.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.authorLattes.none.fl_str_mv |
http://lattes.cnpq.br/7254976533483796 |
dc.contributor.advisorLattes.pt_BR.fl_str_mv |
http://lattes.cnpq.br/3356377676492451 |
dc.contributor.advisor-coLattes.pt_BR.fl_str_mv |
http://lattes.cnpq.br/5874601346158886 |
dc.contributor.author.fl_str_mv |
Bichels, Andre Valente [UNIFESP] |
dc.contributor.advisor1.fl_str_mv |
Kaneko, Maria Ayako Kamimura [UNIFESP] |
dc.contributor.advisor-co1.fl_str_mv |
Silva Júnior, Antonio Carlos Cordeiro |
contributor_str_mv |
Kaneko, Maria Ayako Kamimura [UNIFESP] Silva Júnior, Antonio Carlos Cordeiro |
dc.subject.por.fl_str_mv |
Massa muscular Tomografia computadorizada Composição corporal Doença renal crônica Mortalidade |
topic |
Massa muscular Tomografia computadorizada Composição corporal Doença renal crônica Mortalidade Muscle mass Computed tomography Mortality Chronic kidney disease Body composition |
dc.subject.eng.fl_str_mv |
Muscle mass Computed tomography Mortality Chronic kidney disease Body composition |
description |
Background: In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the loss of skeletal muscle mass. Muscle mass is a key element for evaluation of nutritional disturbances, and low muscle mass is associated with increased morbidity and mortality. An accurate method for muscle mass evaluation that is not subject to errors caused by perturbations in the uremic milieu remains a challenge for the nephrology community. Methods: This is a prospective observational cohort study. We evaluated 223 non-dialyzed CKD patients [60.3±10.6 years; 64% men; 50% diabetics; glomerular filtration rate (GFR) 27.3±16.3 ml/min/1.73m2]. Muscle mass was measured by computed tomography at the third lumbar vertebra region (CTMM-L3) using the Slice-O-Matic software and analyzed according to percentile adjusted by gender. Nutritional parameters, laboratory data and comorbidities were evaluated, and mortality was followed-up for 4 years. Results: During the study period 63 patients died, and the main cause of death was cardiovascular disease. Patients who died were older, had lower GFR, hemoglobin and albumin, as well as lower muscle markers. CTMM-L3 below the 25th percentile was associated with higher mortality according to the Kaplan-Meier curve (P=0.017), and in Cox-regression analysis [crude hazard ratio, HR, 1.87 (95% confidence interval, CI, 1.11-3.16)], also when adjusting for potential confounders [HR 1.83 (CI 1.02-3.30)]. Conclusions: Low muscle mass measured by computed tomography at the third lumbar vertebra region is an independent predictor of increased mortality in non-dialyzed CKD patients. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-05-30 |
dc.date.accessioned.fl_str_mv |
2021-01-19T16:33:50Z |
dc.date.available.fl_str_mv |
2021-01-19T16:33:50Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.pt_BR.fl_str_mv |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7878075 |
dc.identifier.uri.fl_str_mv |
https://repositorio.unifesp.br/handle/11600/59587 |
url |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7878075 https://repositorio.unifesp.br/handle/11600/59587 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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info:eu-repo/semantics/openAccess |
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openAccess |
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São Paulo |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
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Universidade Federal de São Paulo (UNIFESP) |
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Repositório Institucional da UNIFESP |
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