ORIGINAL RESEARCH article
Front. Nephrol.
Sec. Clinical Research in Nephrology
Decreased Quadriceps Muscle Stiffness on Ultrasound Elastography Is Associated with Sarcopenia in End-Stage Kidney Disease (ESKD)
Provisionally accepted
- Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Background: Sarcopenia has emerged as one of the major complications in end-stage kidney disease (ESKD), leading to greater disability and poor long-term outcomes. This study aimed to compare quadriceps muscle sonoelastographic parameters between ESKD patients with and without sarcopenia. Materials and Methods: We prospectively enrolled 50 ESKD patients with sarcopenia and 50 ESKD patients without sarcopenia as controls. All participants underwent clinical and laboratory evaluation, sonoelastography of the quadriceps muscle, and dual-energy X-ray absorptiometry (DXA) for muscle mass assessment. The elastography ratio was calculated as the stiffness of the quadriceps muscle relative to the overlying subcutaneous tissue. Comparisons were made between the sarcopenia and non-sarcopenia groups. Results: A total of 100 ESKD patients were included: 50 with sarcopenia (mean age, 63.0 ± 12.7 years) and 50 without sarcopenia (mean age, 58.3 ± 14.9 years). The sarcopenia group demonstrated a lower quadriceps-to-subcutaneous tissue elastography ratio compared with the control group. Multivariate logistic regression identified the quadriceps-to-subcutaneous tissue ratio, muscle hardness, and body mass index (BMI) as independent predictors of sarcopenia (p < 0.05). Lower BMI was associated with an increased risk of sarcopenia. The optimal quadriceps-to-subcutaneous tissue elastography ratio cut-off value was 0.885 (sensitivity 82.4%; specificity 66.7%) Conclusion: Sonoelastography provides a reliable and non-invasive assessment of quadriceps muscle stiffness and demonstrates good predictive value for detecting sarcopenia in ESKD patients. Given its accessibility, low cost, and ease of use, sonoelastography may serve as a valuable adjunct to conventional DXA in evaluating muscle quality in this high-risk population.
Keywords: End-stage kidney disease (ESKD), Sarcopenia, ultrasound sonoelastography, Dual-energy X-ray absorptiometry (DXA), Quadriceps
Received: 09 Aug 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Chen, Chiu, Chen, Yu and Hsu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ying-Chou Chen, r820713@ms13.hinet.net
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