Kidney Week

Abstract: TH-PO923

Creatinine Filtration as a Novel Index of Muscle Mass and Adverse Outcomes among Older Adults

Session Information

• Geriatric Nephrology: Innovations and Insights
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1300 Geriatric Nephrology

Authors

• Oka, Tatsufumi, Osaka University Graduate School of Medicine, Suita, Japan

Tatsufumi Oka, MD, PhD

• Carrero, Juan Jesus, Karolinska Institutet, Stockholm, Stockholm, Sweden

Juan Jesus Carrero, PharmD, PhD

• Ballew, Shoshana, New York University Grossman School of Medicine, New York, New York, United States

Shoshana Ballew, PhD

• Fu, Edouard, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands

Edouard Fu, PhD

• Sang, Yingying, New York University Grossman School of Medicine, New York, New York, United States

Yingying Sang

• Evans, Marie, Karolinska Institutet, Stockholm, Stockholm, Sweden

Marie Evans, MD, PhD

• Ishigami, Junichi, Johns Hopkins University Center for Health Security, Baltimore, Maryland, United States

Junichi Ishigami, MD, MPH

• Inker, Lesley Ann, Tufts Medical Center, Boston, Massachusetts, United States

Lesley Ann Inker, MD, MS

• Grams, Morgan, New York University Grossman School of Medicine, New York, New York, United States

Morgan Grams, MD, PhD

• Coresh, Josef, New York University Grossman School of Medicine, New York, New York, United States

Josef Coresh, MD, PhD, FASN

• Levey, Andrew S., Tufts Medical Center, Boston, Massachusetts, United States

Andrew S. Levey, MD

Background

Low muscle mass is common among older adults and associated with poor prognosis. Quantifying muscle mass is challenging in routine clinical practice. We previously proposed estimated glomerular filtration of creatinine (eGFcr), the product of serum creatinine (Scr) times estimated GFR using serum cystatin C (Scys) (eGFRcys), as a practical index of muscle mass in older adults, and showed an inverse association with all-cause mortality (Ballew SH, et al. JASN 2023). The association of eGFcr with other clinical outcomes remains uncertain.

Methods

Using data from the SCREAM (Stockholm CREAtinine Measurements) project, a health care utilization cohort in Stockholm, we analyzed 82,154 adults aged ≥65 years who had same-day tests for Scr and Scys. We examined the associations of eGFcr with all-cause and cardiovascular mortality using sex-specific Cox regression models. The associations with recurrent outcomes (hospitalizations, infection, acute kidney injury, myocardial infarction or stroke, and heart failure) were examined using sex-specific negative binomial regression.

Results

At baseline, mean (SD) age and eGFRcys were 75 (8) years and 55 (24) mL/min/1.73 m² in men and 78 (9) years and 53 (23) mL/min/1.73 m² in women, respectively. During follow-up (median, 3.9 years), a lower quintile of eGFcr was significantly associated with a higher risk of all-cause mortality in men (hazard ratio [HR] in the lowest quintile [vs. the highest quintile], 3.74; 95% confidence interval [CI], 3.48–4.03) and in women (HR, 3.34; 95% CI, 3.09–3.60), and cardiovascular mortality in men (HR, 2.88; 95% CI, 2.50–3.32) and in women (HR, 2.92; 95% CI, 2.50–3.41) in multivariable models. A consistent monotonic association was observed in each recurrent outcome (P_trend <0.001) (Figure).

Conclusion

Lower eGFcr was associated with a higher risk of multiple adverse outcomes among community-based older adults. We suggest evaluating the clinical utility of assessing eGFcr in clinical and research settings.

Sex-specific adjusted hazard ratios and incidence rate ratios by quintiles of eGFcr.

Funding

• NIDDK Support