Effect of Sarcopenia on Post-Contrast Acute Kidney Injury in Patients with Abdominal Aortic Aneurism Treated with Endovascular Aneurysm Repair

Purpose: Sarcopenia is a syndrome presenting with progressive and generalized skeletal muscle loss and disability. Its incidence is higher among the elderly. Recent studies have reported an association between sarcopenia and postoperative acute kidney injury (AKI). However, the association between sarcopenia and post-contrast AKI (PC-AKI) remains uninvestigated. This study aimed to assess the association between sarcopenia and the development of PC-AKI in patients with abdominal aortic aneurysm who underwent endovascular aneurysm repair (EVAR). Method: We included 109 patients in the study. PC-AKI was defined as a serum creatinine (SCr) concentration increase of ≥ 0.3 mg/dL or ≥ 1.5-1.9 times the baseline value within 72 hours after the EVAR procedure. Sarcopenia was defined as a skeletal mass index (SMI) of ≤ 52.4 cm^2/m^2 for men and ≤ 38.5 cm^2/m^2 for women. SMI was calculated by dividing the cross-sectional area of the skeletal muscle measured using preoperative abdominal computed tomography (CT) by the height in square meters. Results: The baseline demographic, laboratory, and medication data were similar in patients with and without sarcopenia. PC-AKI developed in 10 (19.2%) and 7 patients (12.3%) in the sarcopenia and non-sarcopenia groups, respectively (p = 0.31). Multivariate logistic regression analysis showed that the baseline Scr value (odds ratio [OR], 4.075; 95% confidence interval [CI]), 1.277-13.000; p = 0.01), and the use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers (OR, 3.940; 95% CI, 1.191–13.085; p = 0.02) are independent determinants of PC-AKI. Conclusion: Sarcopenia is not associated with the development of PC-AKI. Patients with sarcopenia should be evaluated for classical risk factors of PC-AKI.