Associations of Low Muscle Mass and Myosteatosis With Kidney Transplant Outcomes: A Systematic Review and Meta-Analysis.
Li, Y., et al.J Ren Nutr. 2026 Jan;36(1):4-12.
Aims
This study aimed to investigate whether data on low muscle mass (LMM) and myosteatosis is able to predict posttransplant outcomes in kidney transplant recipients.
Interventions
A literature search was performed using three databses: PubMed, EMBASE, and the Cochrane Library. Study selection and data extraction were performed by two independent authors. The methodological quality of the included studies were assessed using the Newcastle-Ottawa Scale.
Participants
13 studies were included in the review.
Outcomes
Primary outcomes included patient survival and graft survival, and secondary outcomes were complications, acute rejection, delayed graft function, early readmission, intensive care unit admission, length of hospital stay and infection.
Follow-up
N/A
CET Conclusions
This systematic review examines the predictive ablity of LMM and myosteatosis data for outcomes in kidney transplant recipients. Two independent reviewers selected studies and extracted data. A total of 13 retrospective cohort studies were included. The authors found that patients with LMM were at a significantly higher risk of mortality and graft loss, and were also significantly more likely to be readmitted to the hospital at 1 and 3 months. Similar results were observed with patients with myosteatosis with regard to patient mortality and graft loss. Heterogeneity was low for these outcomes. The authors therefore recommend use of preoperative CT-derived muscle mass and density data during pretransplant evaluations. No separate analysis were performed for living versus deceased donor recipients. The analyses did not adjust for potential confounders which may have led to an overestimation of effect size and the authors acknowledge this. Another limitation of this study was the low number of studies (<3) for some of the outcomes in the meta-analysis making it hard to draw firm conclusions.
Trial registration
PROSPERO - CRD42024583007