January 31, 2022
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The difference between eGFR-cystatin and eGFR-creatinine reveals information on the renal functional status of older adults, which can be explained to some extent by muscle mass and quality, according to data published in Kidney medicine.
“The difference in eGFR from cystatin C (eGFRCys) vs. creatinine (eGFRCr) has been shown to include information on functional status, fragility and risk of death in older adults.” O. Alison Potok, MD, from the Department of Nephrology-Hypertension at the University of California at San Diego, and colleagues wrote. “The aim of this study was to determine whether muscle mass explains the association between this difference (eGFRDiff = eGFRCys – eGFRCr) with functional status. “
In a cohort analysis of the Health, Aging and Body Composition (HABC) study, researchers evaluated 2,970 participants (48% were men; 41% were black; mean age was 74 ± 3 years) with cystatin C, creatinine, and muscle mass imaging at baseline.
CKD-EPI equations determined participants’ eGFRs, and researchers used the equation (eGFR)Cys – eGFRCr) to calculate eGFRDiff. In addition, they measured the thigh muscle area of participants with computed tomography.
Using linear regression, researchers modeled the cross-sectional correlation between eGFRDiff and muscle measurements. Similarly, researchers used logistic regression to determine the association between eGFRDiff with poor functional status.
The mean eGFRCys, eGFRCr and eGFRDiff were 72 mL / min / 1.73 m², 68 mL / min / 1.73 m² and 4 mL / min / 1.73 m², respectively. Participants in the negative eGFRDiff group (–10 mL / min / 1.73 m²) showed a higher risk of comorbidities, slower gait, and poorer functional status compared with those in the reference group (–10
“This study confirms previous results that the difference in eGFR between cystatin C and creatinine is clinically relevant and strongly associated with poor functional performance in well-functioning older adults living in the community. We demonstrate here that lower eGFRDiff is also strongly associated with lower Although eGFRDiff is associated with lower muscle mass, low muscle mass did not significantly weaken the relationship between eGFRDiff and functional status, “Potok and colleagues wrote.” Future studies are needed to better understand the determinants of this difference in muscle mass. to understand mechanisms responsible for its strong and consistent relationship to fragility, mortality and other clinical outcomes. “