BACKGROUND AND OBJECTIVES: Previous studies in chronic disease states have demonstrated an association between lower urinary creatinine excretion (UCr) and increased mortality, a finding presumed to reflect the effect of low muscle mass on clinical outcomes. Little is known about the relationship between UCr and other measures of body composition in terms of the ability to predict outcomes of interest. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data from the Chronic Renal Insufficiency Cohort (CRIC), the relationship between UCr, fat free mass (FFM) as estimated by bioelectrical impedance analysis, and (in a subpopulation) whole-body dual-energy x-ray absorptiometry assessment of appendicular lean mass were characterized. The associations of UCr and FFM with mortality and ESRD were compared using Cox proportional hazards models. RESULTS: A total of 3604 CRIC participants (91% of the full CRIC cohort) with both a baseline UCr and FFM measurement were included; of these, 232 had contemporaneous dual-energy x-ray absorptiometry measurements. Participants were recruited between July 2003 and March 2007. UCr and FFM were modestly correlated (rho=0.50; P<0.001), while FFM and appendicular lean mass were highly correlated (rho=0.91; P<0.001). Higher urinary urea nitrogen, black race, younger age, and lower serum cystatin C level were all significantly associated with higher UCr. Over a median (interquartile range) of 4.2 (3.1-5.0) years of follow-up, 336 (9.3%) participants died and 510 (14.2%) reached ESRD. Lower UCr was associated with death and ESRD even after adjustment for FFM (adjusted hazard ratio for death per 1 SD higher level of UCr, 0.63 [95% confidence interval, 0.56 to 0.72]; adjusted hazard ratio for ESRD per 1 SD higher level of UCr, 0.70 [95% confidence interval, 0.63 to 0.75]). CONCLUSIONS: Among a cohort of individuals with CKD, lower UCr is associated with death and ESRD independent of FFM as assessed by bioelectrical impedance analysis.
BACKGROUND AND OBJECTIVES: Previous studies in chronic disease states have demonstrated an association between lower urinary creatinine excretion (UCr) and increased mortality, a finding presumed to reflect the effect of low muscle mass on clinical outcomes. Little is known about the relationship between UCr and other measures of body composition in terms of the ability to predict outcomes of interest. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data from the Chronic Renal Insufficiency Cohort (CRIC), the relationship between UCr, fat free mass (FFM) as estimated by bioelectrical impedance analysis, and (in a subpopulation) whole-body dual-energy x-ray absorptiometry assessment of appendicular lean mass were characterized. The associations of UCr and FFM with mortality and ESRD were compared using Cox proportional hazards models. RESULTS: A total of 3604 CRIC participants (91% of the full CRIC cohort) with both a baseline UCr and FFM measurement were included; of these, 232 had contemporaneous dual-energy x-ray absorptiometry measurements. Participants were recruited between July 2003 and March 2007. UCr and FFM were modestly correlated (rho=0.50; P<0.001), while FFM and appendicular lean mass were highly correlated (rho=0.91; P<0.001). Higher urinary ureanitrogen, black race, younger age, and lower serum cystatin C level were all significantly associated with higher UCr. Over a median (interquartile range) of 4.2 (3.1-5.0) years of follow-up, 336 (9.3%) participants died and 510 (14.2%) reached ESRD. Lower UCr was associated with death and ESRD even after adjustment for FFM (adjusted hazard ratio for death per 1 SD higher level of UCr, 0.63 [95% confidence interval, 0.56 to 0.72]; adjusted hazard ratio for ESRD per 1 SD higher level of UCr, 0.70 [95% confidence interval, 0.63 to 0.75]). CONCLUSIONS: Among a cohort of individuals with CKD, lower UCr is associated with death and ESRD independent of FFM as assessed by bioelectrical impedance analysis.
Authors: Ursula G Kyle; Ingvar Bosaeus; Antonio D De Lorenzo; Paul Deurenberg; Marinos Elia; José Manuel Gómez; Berit Lilienthal Heitmann; Luisa Kent-Smith; Jean-Claude Melchior; Matthias Pirlich; Hermann Scharfetter; Annemie M W J Schols; Claude Pichard Journal: Clin Nutr Date: 2004-10 Impact factor: 7.324
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Authors: Paula F Orlandi; Dawei Xie; Wei Yang; Jordana B Cohen; Rajat Deo; Ana C Ricardo; Sarah Schrauben; Xue Wang; L Lee Hamm; Jiang He; James H Sondheimer; Krishna Kallem; Raymond Townsend; Dominic Raj; Afshin Parsa; Amanda H Anderson; Harold I Feldman Journal: J Am Soc Nephrol Date: 2020-10-06 Impact factor: 10.121
Authors: Robert E Olivo; Clemontina A Davenport; Clarissa J Diamantidis; Nrupen A Bhavsar; Crystal C Tyson; Rasheeda Hall; Aurelian Bidulescu; Bessie Young; Stanford E Mwasongwe; Jane Pendergast; L Ebony Boulware; Julia J Scialla Journal: Nephrol Dial Transplant Date: 2018-06-01 Impact factor: 5.992