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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Lean tissue index (LTI), an indicator of muscle mass and nutritional status in dialysis patients, is associated with adverse outcomes, but its longitudinal trends in multiethnic Asian populations remain poorly characterized. This study examines two-year LTI trajectories, clinical, biochemical, and treatment variables, and explores their associations with hospitalization and mortality among incident HD patients in Singapore.
Adult incident HD patients treated at Fresenius Kidney Care (FKC) clinics in Singapore between January 2019 - July 2024 were included if their first LTI measurement occurred within three months of HD initiation and at least one subsequent value during follow-up was available. LTI, Fat Tissue Index (FTI), and Overhydration (OH) were assessed using the Body Composition Monitor (BCM; Fresenius Medical Care). Patients were categorized according to early LTI change between the baseline (two months after the first LTI: BM1 and BM2 assessments) as ≥ 10% decrease, ≥ 10% increase, <10% change or change unknown. Associations between early LTI change and outcomes over two years were examined using Cox and Poisson regression models.
Among 1376 patients, the overall mean age was 64.1 years, BMI 24.2 kg/m², 40% were female, 55% were Chinese, 33% had diabetes, 2% had heart failure, and 10% had hypertension. Over two years, LTI modestly declined from 11.16 to 11.03 kg/m² (Table-1). Across all groups, the intensity of change was greater in the first year, where most lean mass loss or gain occurred, while the second half showed stabilization. Treatment frequency remained stable, while increases were observed in effective treatment time (232 to 236 min), mean blood flow (260 to 287 mL/min), fistula access (20% to 80%), and the HDF treatments (6% to 38%).
During follow-up, mortality rates were 4.5% in LTI decreased group (n = 245), 2.2% in LTI increased group (n = 226), and 3.5% in LTI unchanged group (n = 689). Adjusted hazard ratios were higher for decreased LTI (1.19 (95% CI 0.46–3.07, p = 0.72)) and lower for increased LTI ((0.67 (0.21–2.15, p=0.50)) versus the unchanged group) (Table 2). Hospitalization rates were similar across the three groups: 3.19, 2.96 and 3.01 per person year for LTI decreased, increased and unchanged groups respectively, with adjusted rate ratios of 0.92 (0.84–1.00, p = 0.06) for decreased LTI and 0.96 (0.88–1.06, p = 0.44) for increased LTI compared to the unchanged group (Table 3).
Lab and treatment parameters demonstrated similar trends across the three groups, however the LTI increased group demonstrated slightly higher serum albumin, nPCR, total calcium, and serum phosphorus levels, and lower ferritin levels; greater reductions in CRP was observed in the LTI increased group compared to the LTI decreased group (Figure 1).
In this large Singaporean HD cohort, LTI remained largely stable over two years, with the greatest changes observed early after dialysis initiation. Although LTI gain tended to be associated with better outcomes, statistical significance was not reached, underscoring the need for longer-term studies. Further investigation into factors driving early lean mass changes—and their potential prognostic relevance is warranted.
