Hemodialysis patients frequently face the problem of reduced muscle strength and exercise capacity which reduces their autonomy, and quality of life and reduces survival time.

Studies on elderly patients have suggested that the decline of muscle quality is closely related to the decline in physical function and poor prognosis of patients. An assessment may allow clinicians in formulating intervention measures and improve prognosis. Several imaging methods are used to estimate the muscle composition to suggest the muscle quality including computed tomography (CT), magnetic resonance imaging (MRI) and muscle radiation attenuation by CT. These give an assessment of the 

• Adipose tissue and lipid filtration
• Loss in tissue elasticity
• Relative fluid expansion. 

However, there are few imaging studies conducted on patients on hemodialysis. An earlier study demonstrated that CT measurement of mid-thigh intermuscular adipose tissue predicts usual gait velocity and 6-minute walk distance of patients on hemodialysis. 

Reference

Wu J, Luo H, Ren S, Shen L, et al. Enhanced echo intensity of skeletal muscle is associated with poor physical function in hemodialysis patients: a cross-sectional study. BMC Nephrol. 2022;23(1):186.