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

Abstract

Introduction: We aimed to evaluate the association of a decreased glomerular-filtration-rate (GFR<60ml/min/1.73m(2)), 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 aged60 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 67.86.4) were enrolled. Sixty-two patients (29.7%) had sarcopenic HGS. Subjects with sarcopenic HGS were older, had higher rate of a GFR<60ml/min/1.73m(2), 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 60ml/min/1.73 m(2) 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 <60ml/min/1.73 m(2) with sarcopenic HGS, when CKDEPI-CC formula is used.