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Abstract: PO1750

Serum Cystatin C-to-Creatinine Ratio Is a Potential Biomarker for Sarcopenia in Patients with Non-Dialysis-Dependent CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Cho, Illeon, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Choi, Yong Seon, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • An, Jung Nam, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Kim, Sung gyun, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
  • Song, Young rim, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
Background

Sarcopenia is a prevalent complication in patients with chronic kidney disease (CKD) and linked with quality of life, morbidity and mortality. Sarcopenia is defined as clinical, functional and body compositional parameters, although several candidate biomarkers for this condition have been evaluated. This study aimed to evaluate serum cystatin C to creatinine (Cr) ratio as a potential biomarker for sarcopenia in patients with non-dialysis dependent CKD.

Methods

A total of 517 outpatients were enrolled in this observational cohort study. We measured the muscle mass (lean tissue index, LTI) using bioimpedance analysis and handgrip strength (HGS), and sarcopenia was defined as low HGS and low muscle mass.

Results

Sarcopenia was observed in 25.5% patients. The serum cystatin C/Cr ratio was significantly higher in patients with sarcopenia regardless of age, sex, eGFR, and BMI; and showed a positive correlation with age and pulse pressure, but LTI, HGS, hemoglobin, and serum albumin level showed a negative correlation with serum cystatin C/Cr ratio. Especially in patients with eGFR ≥ 45 mL/min/1.73 m2, serum cystatin C/Cr ratio showed high negative predictive value in predicting sarcopenia (90.5%) and low LTI (90.4%). As the serum cystatin C/Cr ratio increased by 1, the prevalence risk of sarcopenia and low LTI increased by about 5.8 times and about 9.9 times even after adjusting for sex, age, BMI, underlying disease, albumin, Hb, and eGFR. The association between serum cystatin C/Cr ratio and sarcopenia was maximized in patients with eGFR less than 30, resulting in an increased prevalence risk of about 22.7 times, and in the case of low LTI, an independent association was found in patients with eGFR less than 45, and among them, a 43.9-fold increase in risk was identified. However, there was also no significant result for low HGS.

Conclusion

Serum cystatin C/Cr ratio is inexpensive and easily, quickly, and repeatedly measured; therefore, quick screening and management of sarcopenia will be possible, which will be of great help in the treatment of CKD patients.