The relative effects of fat versus muscle mass on cystatin C and estimates of renal function in healthy young men

Chew-Harris, Janice; Florkowski, Christopher M; George, Peter M.; Elmslie, Jane; Endre, Zoltán H.

doi:10.1258/acb.2012.011241

Cited by 66 publications

(57 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings of cystatin C based equations being influenced by obesity are supported by other studies [28] including Asian and Indigenous populations [29][30][31]. One observational study of immigrant South Asians was also able to demonstrate that the relationship between increasing adiposity and eGFRcysC was largely explained by factors related with chronic inflammation, including c-reactive protein [30].…”

Section: Discussionsupporting

confidence: 87%

Comparison of creatinine and cystatin C based eGFR in the estimation of glomerular filtration rate in Indigenous Australians: The eGFR Study

Barr

Maple-Brown

Barzi

et al. 2017

Clinical Biochemistry

View full text Add to dashboard Cite

Background: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation that combines creatinine and cystatin C is superior to equations that include either measure alone in estimating glomerular filtration rate (GFR). However, whether cystatin C can provide any additional benefits in estimating GFR for Indigenous Australians, a population at high risk of end-stage kidney disease (ESKD) is unknown.

show abstract

Section: Discussionsupporting

confidence: 87%

Comparison of creatinine and cystatin C based eGFR in the estimation of glomerular filtration rate in Indigenous Australians: The eGFR Study

Barr

Maple-Brown

Barzi

et al. 2017

Clinical Biochemistry

View full text Add to dashboard Cite

show abstract

“…The known effects of muscle mass/creatinine generation on the serum creatinine concentration and the known effects of fat mass on the serum cystatin C concentration (more fat mass is associated with higher cystatin C concentrations) likely results in an underestimation of the prevalence of sarcopenia when eGFR Cr is used and an overestimation of the prevalence of obesity when eGFR Cys is used. [34] This finding highlights the complexity of studying sarcopenia and obesity in the CKD population and either the application of other marker solutes (e.g., beta trace protein) when studying the association between CKD and body composition, or at a minimum, the recognition that conventional GFR-estimating equations can be biased by alterations from the typical muscle or fat mass.…”

Section: Discussionmentioning

confidence: 98%

Sarcopenia, Relative Sarcopenia and Excess Adiposity in Chronic Kidney Disease

Ziolkowski

Long

Baker

et al. 2018

JCSM Clinical Reports

View full text Add to dashboard Cite

Aims Conventional definitions of sarcopenia based on lean mass fail to capture low lean mass relative to fat mass, i.e., relative sarcopenia. Unlike percent body fat (%BF) and Quételet's (body mass) index (BMI, kg/m 2 ), definitions of obesity based on fat mass index (FMI, kg/m 2 ) are not confounded by lean mass. The objective is to determine the prevalence of sarcopenia, relative sarcopenia, and obesity in CKD, and determine if CKD is associated with relative sarcopenia and obesity, independent of demographics and comorbidities.Methods and Results DXA-derived appendicular lean mass index (ALMI, kg/m 2 ) and FMI were assessed in 13,980 NHANES participants. ALMI, FMI, and ALMI relative to FMI (ALMI FMI ) were expressed as sex-and race/ethnicity-specific standard deviation scores compared with young adults (T-scores) and by age (Z-scores). Sarcopenia was defined as ALMI T-score < -2, relative sarcopenia as ALMI FMI T-score < -2, and low lean mass relative to fat mass for age as ALMI FMI Z-score < -1. Obesity was defined using conventional BMI and %BF cutpoints and as sex-and race/ethnicity-specific FMI cutpoints. Glomerular filtration rate (GFR) was estimated using creatinine-(eGFR Cr ) and cystatin C-(eGFR Cys ). The prevalence of relative sarcopenia was higher than the prevalence of sarcopenia, especially in CKD stages 3b and 4 using eGFR Cr ; these CKD stages were associated with the highest FMI. CKD stage was independently associated with low ALMI FMI for age using eGFR Cys . BMI underestimated and %BF overestimated the prevalence of obesity compared with FMI. CKD was not independently associated with obesity by FMI. ConclusionsIn CKD, conventional definitions of sarcopenia underestimate muscle deficits and %BF overestimates the prevalence of obesity. CKD is independently associated with relative sarcopenia, but not excess adiposity.

show abstract

“…Plasma cystatin C was measured using a particleenhanced nephelometric immunoassay on a Behring Nephelometer II analyzer (Siemens Diagnostics, Marburg, Germany), with a CV <4.5% [27]. The use of this assay for cystatin C is consistent with the recommendations by Shlipak et al [28].…”

Section: Gentamicin Creatinine and Cystatin C Assaysmentioning

confidence: 68%

The performance of contemporary cystatin C‐based GFR equations in predicting gentamicin clearance

Chin

Chew-Harris

Florkowski

et al. 2015

Brit J Clinical Pharma

View full text Add to dashboard Cite

AIMSWe aimed to compare the performances of contemporary cystatin C (Cys)-based GFR equations, and the creatinine only Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for predicting gentamicin clearance. METHODSThe bias and imprecision of the CKD-EPI, CKD-EPI_Cys and creatinine-cystatin C CKD-EPI (CKD-EPI_CrCys) equations for predicting gentamicin clearances, were assessed in 260 patients treated with gentamicin during 2012-2013. The creatinine-cystatin C Berlin Initiative Study equation (BIS_CrCys) was examined in the ≥70 year subgroup. The reference gentamicin clearance was calculated using post-dose plasma concentrations. RESULTSThe CKD-EPI_CrCys equation had the highest percentage of estimates within 30% of the reference gentamicin clearance (70%, P = 0.003) and lowest root mean square error (95% CI) of 29 (25, 23) ml min −1 of the three equations for the entire cohort. There was no significant improvement in the performances of the equations with the exclusion of 41 patients with abnormal thyroid function tests or steroid co-prescription at the time of the index gentamicin dose. Of the remaining 219 patients, adjustment for individual BSA improved the performances of all GFR equations (P ≤ 0.003) in those with body mass indices (BMI) <18.5 or ≥30 kg m CONCLUSIONSThe CKD-EPI_CrCys equation provided the best estimate of gentamicin clearance. If used for guiding gentamicin dosing, the results from GFR equations should be adjusted for individual BSA at the extremes of body size.

show abstract

The relative effects of fat versus muscle mass on cystatin C and estimates of renal function in healthy young men

Cited by 66 publications

References 46 publications

Comparison of creatinine and cystatin C based eGFR in the estimation of glomerular filtration rate in Indigenous Australians: The eGFR Study

Comparison of creatinine and cystatin C based eGFR in the estimation of glomerular filtration rate in Indigenous Australians: The eGFR Study

Sarcopenia, Relative Sarcopenia and Excess Adiposity in Chronic Kidney Disease

The performance of contemporary cystatin C‐based GFR equations in predicting gentamicin clearance

Contact Info

Product

Resources

About