Ultrasound quadriceps muscle thickness is variably associated with frailty in haemodialysis recipients

Benjamin M Anderson, Daisy V Wilson, Muhammad Qasim, Gonzalo Correa, Felicity Evison, Suzy Gallier, Charles J Ferro, Thomas A Jackson, Adnan Sharif*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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BACKGROUND: Ultrasonographic quantitation of quadriceps muscle mass is increasingly used for assessment of sarcopenia, but its relationship with frailty in haemodialysis recipients is not known. This study explores the relationship between ultrasound-derived bilateral anterior thigh thickness (BATT), sarcopenia, and frailty by common frailty tools (Frailty Phenotype [FP], Frailty Index [FI], Edmonton Frailty [EFS], and Clinical Frailty Scale [CFS]).

METHODS: This was an exploratory analysis of a subgroup of adult prevalent (≥3 months) haemodialysis recipients deeply phenotyped for frailty. Ultrasound assessment of BATT was obtained with participants at an angle of ≤45°, with legs outstretched and knees resting at 10°-20°, according to an established protocol. Associations with frailty were explored via both linear and logistic regressions for BATT, Low Muscle Mass (LMM), and sarcopenia with stepwise adjustment for a priori covariables.

RESULTS: In total 223 study participants had ultrasound measurements. Frailty ranged from 34% for FP to 58% for FI. BATT was associated with increasing frailty on simple linear regression by all frailty tools, but lost significance on addition of covariables. Upon dichotomising frailty tools into Frail/Not Frail, BATT was associated with frailty by all tools on univariable analyses, but only retained association for EFS on the fully adjusted model (OR 0.97, 95% C.I. 0.94-1.00, P = 0.05).

CONCLUSIONS: Ultrasound measures of quadriceps thickness is variably associated with frailty in prevalent haemodialysis recipients, dependent upon the frailty tool used, but not independent of other variables. Further work is required to establish the added value of sarcopenia measurement in frail haemodialysis patients.

TRIAL REGISTRATION: Clinicaltrials.gov : NCT03071107 registered 06/03/2017.

Original languageEnglish
Article number16
JournalBMC Nephrology
Issue number1
Publication statusPublished - 18 Jan 2023

Bibliographical note

© 2023. The Author(s).


  • Aged
  • Humans
  • Frail Elderly
  • Frailty/diagnostic imaging
  • Geriatric Assessment/methods
  • Quadriceps Muscle/diagnostic imaging
  • Renal Dialysis/adverse effects
  • Sarcopenia/diagnostic imaging
  • Research
  • Epidemiology
  • Sarcopenia
  • Frailty
  • Ultrasound


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