Association of muscle mass and radiodensity assessed by chest CT with all-cause and cardiovascular mortality in hemodialysis patients

Purpose This study investigates the prognostic value of skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) measured by chest CT in relation to all-cause and cardiovascular disease (CVD) mortality among hemodialysis (HD) patients. Methods A retrospective study was conducted from January 2015 to December 2021 involving HD patients at a dialysis center. Chest CT scans at the twelfth thoracic vertebra level (T12) were analyzed to assess SMI and SMD. Sex-specific cut-off values for two metrics were determined using maximally selected rank statistics. Hazard ratios (HRs) were calculated to evaluate the associations of SMI and SMD with mortality. The discrimination of prognostic models was also compared. Results The study included 603 patients with a median age of 58 years. Of these, 187 (31.0%) patients with SMI