Clinical and predictive value of simplified creatinine index used as muscle mass surrogate in end-stage kidney disease haemodialysis patients—results from the international MONitoring Dialysis Outcome initiative - Université de Montpellier Accéder directement au contenu
Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2020

Clinical and predictive value of simplified creatinine index used as muscle mass surrogate in end-stage kidney disease haemodialysis patients—results from the international MONitoring Dialysis Outcome initiative

Résumé

Background: Protein-energy wasting, muscle mass (MM) loss and sarcopenia are highly prevalent and associated with poor outcome in haemodialysis (HD) patients. Monitoring of MM and/or muscle metabolism in HD patients is of paramount importance for timely detection of muscle loss and to intervene adequately. In this study we assessed the reliability and reproducibility of a simplified creatinine index (SCI) as a surrogate marker of MM and explored its predictive value on outcome. Method: We included all in-centre HD patients from 16 European countries with at least one SCI. The baseline period was defined as 30 days before and after the first multifrequency bioimpedance spectroscopy measurement; the subsequent 7 years constituted the follow-up. SCI was calculated by the Canaud equation. Multivariate Cox proportional hazards models were applied to assess the association of SCI with all-cause mortality. Using backward analysis, we explored the trends of SCI before death. Bland-Altman analysis was performed to analyse the agreement between estimated and measured MM. Results: We included 23 495 HD patients; 3662 were incident. Females and older patients have lower baseline SCI. Higher SCI was associated with a lower risk of mortality [hazard ratio 0.81 (95% confidence interval 0.79-0.82)]. SCI decline accelerated ∼5-7 months before death. Lean tissue index (LTI) estimated by SCI was correlated with measured LTI in both sexes (males: R2 = 0.94; females: R2 = 0.92; both P < 0.001). Bland-Altman analysis showed that measured LTI was 4.71 kg/m2 (±2 SD: -12.54-3.12) lower than estimated LTI. Conclusion: SCI is a simple, easily obtainable and clinically relevant surrogate marker of MM in HD patients.
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hal-03342590 , version 1 (13-09-2021)

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Paternité - Pas d'utilisation commerciale

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Bernard Canaud, Xiaoling Ye, Len Usvyat, Jeroen Kooman, Frank van Der Sande, et al.. Clinical and predictive value of simplified creatinine index used as muscle mass surrogate in end-stage kidney disease haemodialysis patients—results from the international MONitoring Dialysis Outcome initiative. Nephrology Dialysis Transplantation, 2020, 35 (12), pp.2161-2171. ⟨10.1093/ndt/gfaa098⟩. ⟨hal-03342590⟩

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