Relationships between cystatin C- and creatinine-based eGFR in Japanese rural community- dwelling older adults with sarcopenia

Abstract

Background Sarcopenia is prevalent in patients with chronic kidney disease (CKD). The indices of physical function, such as grip power and gait speed, decreased according to the decline in the estimated glomerular filtration rate (eGFR). Methods We examined the relationships between cystatin C-based GFR (eGFRcys), creatinine-based GFR (eGFRcre), their ratio (eGFRcys/eGFRcre) and sarcopenia in community-dwelling older adults in Japan. This cross-sectional study included 302 men aged 73.9 ± 6.2 years and 647 women aged 72.9 ± 5.8 years from a rural area in Hyogo Prefecture, Japan. eGFRcys and eGFRcre were simultaneously measured, and sarcopenia based on the Asia Working Group for Sarcopenia (AWGS) 2019 criteria was evaluated. Results eGFRcys and the eGFRcys/eGFRcre ratio were significantly correlated with grip power and gait speed (p < 0.001). The eGFRcys/eGFRcre ratio was also correlated with skeletal muscle mass index (SMI) (p < 0.01). Univariate logistic regression analysis showed eGFRcys and eGFRcys/eGFRcre ratio but not eGFRcre were associated with sarcopenia (p < 0.01). The presence of low eGFRcys (CKDcys) and low eGFRcys/eGFRcre ratio (< 1.0) but not that of low eGFRcre (CKDcre) were associated with sarcopenia (p < 0.01). In the multivariate logistic regression analysis, when the eGFRcys/eGFRcre ratio was added as a covariate to the basic model, it was significantly associated with sarcopenia in women (p < 0.05). Moreover, low eGFRcys/eGFRcre ratio (< 1.0) was associated with a higher risk of sarcopenia in men (p < 0.01). Conclusion In conclusion, CKDcys but not CKDcre is associated with sarcopenia. A lower eGFRcys/eGFRcre ratio may be a practical screening marker of sarcopenia in community-dwelling older adults.

A Novel Application of Serum Creatinine and Cystatin C to Predict Sarcopenia in Advanced CKD

“…Given the decreased serum creatinine, but not cystatin C, in patients experiencing muscle wasting, other indices based on these two renal markers, such as the creatinine-to-cystatin C ratio (Cr/CysC), eGFRcys-to-eGFRcre ratio (eGFRcys/eGFRcre), and the difference between eGFRcys and eGFRcre (eGFRcys-eGFRcre), have been reported for the assessment of sarcopenia in various populations (31)(32)(33)(34)(35)(36)(37)(38)(39). Our study demonstrated that, among these serum indices, Cr×eGFRcys exhibited the best correlations with skeletal muscle mass, strength, and gait speed.…”

Assessment of sarcopenia and malnutrition using estimated GFR ratio (eGFRcys/eGFR) in hospitalised adult patients

“…However, they analysed the diagnostic efficacy of the eGFR ratio without calculating SMI. The AUC of ROC analysis was relatively low (0.630e0.693) [21]. Kusunoki et al suggested the predicted SMI (pSMI) obtained from regression equation containing creatinine/ cystatin C ratio, age, and haemoglobin concentration [22].…”

Comparison of Creatinine and Cystatin C to Estimate Renal Function in Geriatric and Frail Patients

“…Muscle mass decreases with age, which masks deteriorated renal function due to lower creatinine levels [49][50][51][52]. A number of cross-sectional studies have shown correlation between sarcopenia and increasing creatinine-cystatin C ratio, i.e., the sarcopenia index [13,49,[53][54][55]. No study has investigated the relationship between sarcopenia and accuracy of eGFR.…”