We read with great interest the study by Dha Woon Im et al. in the American Journal of Kidney Diseases, “Associations of Skeletal Muscle Mass and Body Mass Index With Clinical Outcomes in Autosomal Dominant Polycystic Kidney Disease1.” In a multicenter real-world cohort using AI-based body-composition quantification, the authors report that higher muscle quality is associated with lower all-cause mortality and possibly lower ESKD risk, whereas greater low-attenuation muscle area is linked to higher ESKD risk, with heterogeneity across BMI strata.