Low glomerular filtration rate as an associated risk factor for sarcopenic muscle strength: is creatinine or cystatin C-based estimation more relevant?

Aging Male. 2017 Jun;20(2):110-114. doi: 10.1080/13685538.2016.1225032. Epub 2016 Sep 20.

Abstract

Introduction: We aimed to evaluate the association of a decreased glomerular-filtration-rate (GFR <60 ml/min/1.73 m2), estimated using Modification of Diet in Renal Disease (MDRD), creatinine- and cystatin C-based (CKDEPI-CR and CKDEPI-CC) Chronic Kidney Disease Epidemiology Collaboration equations with handgrip strength (HGS).

Methods: Community-dwelling males aged ≥60 years admitted to outpatient clinic were included. We used MDRD, CKDEPI-CR, and CKDEPI-CC formulas for GFR estimation and corrected these for body surface area. Muscle strength was assessed by HGS.

Results: 209 men (mean age 67.8 ± 6.4) were enrolled. Sixty-two patients (29.7%) had sarcopenic HGS. Subjects with sarcopenic HGS were older, had higher rate of a GFR < 60 ml/min/1.73 m2, had lower mid-upper arm circumference; tended to have lower creatine kinase, albumin, CKDEPI-CC-GFR levels; and higher BUN/creatinine ratio and cystatin C. Multivariate logistic regression analysis revealed a CKDEPI-CC lower than 60 ml/min/1.73 m2 as the only independent factor underlying sarcopenic HGS. Higher age tended to have an independent association. Only higher age was independently associated with low HGS when other estimations were used (p = 0.013 and p = 0.021 when MDRD and CKDEPI-CR were used, respectively).

Conclusions: There is a strong association of a GFR level of <60 ml/min/1.73 m2 with sarcopenic HGS, when CKDEPI-CC formula is used.

Keywords: Male; extracorporeal shock-wave therapy; sarcopenia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Chi-Square Distribution
  • Creatinine / blood*
  • Cross-Sectional Studies
  • Cystatin C / blood*
  • Glomerular Filtration Rate*
  • Hand Strength / physiology*
  • Humans
  • Middle Aged
  • Predictive Value of Tests
  • Renal Insufficiency, Chronic / complications
  • Risk Factors
  • Sarcopenia / complications
  • Sarcopenia / physiopathology*
  • Statistics, Nonparametric

Substances

  • Biomarkers
  • Cystatin C
  • Creatinine