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Ratio of serum creatinine to cystatin C is related to leg strength in predialysis CKD patients

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Abstract

Background and objectives

Chronic kidney disease (CKD) patients have lower levels of physical function. Especially, leg strength is important for daily living and preventing falls. However, physical function screenings are difficult to perform at clinical sites. To find clinically useful method to evaluate physical function in predialysis CKD patients, we tried to evaluate the relationship between the ratio of serum creatinine to serum cystatin C (Cre/CysC), and knee extensor muscle strength/body weight (KEMS) which reflects their leg strength.

Design, setting, participants, and measurements

We recruited 147 outpatients with CKD (87 men; mean age, 61.6 ± 9.8 years; mean eGFRcreat, 40.7 ± 12.9 mL/min/1.73m2) in this cross-sectional study. KEMS was assessed using a wire strain gauge dynamometer. Skeletal muscle mass and body fat mass were assessed by bioelectrical impedance analysis.

Results

The mean value of Cre/CysC was 1.01 ± 0.18. The mean value of KEMS was 1.60 ± 0.47 Nm/kg. In multivariate linear regression analysis, skeletal muscle mass (p < 0.01), body fat mass (p < 0.01), hemoglobin (p = 0.01), and Cre/CysC (p < 0.01) was independently related to KEMS. The correlation between Cre/CysC and KEMS is stronger in high quantile of Cre/CysC.

Conclusions

In predialysis CKD patients, KEMS showed lower as CKD stage advanced. Cre/CysC is significantly related to KEMS independently. Cre/CysC may be an alternative marker for leg strength in CKD patients and even more valuable to utilize in cases with high Cre/CysC.

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Authors and Affiliations

  1. Degree Programs in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Kohei Shiomi

  2. Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Chie Saito, Kei Nagai, Tetsuya Kawamura, Shuzo Kaneko, Hirayasu Kai, Naoki Morito, Joichi Usui & Kunihiro Yamagata

  3. Faculty of Sports Science, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Keisei Kosaki

  4. Department of Medical Science and Welfare, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan

    Hisako Yanagi

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  1. Kohei Shiomi
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Correspondence to Kunihiro Yamagata.

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Shiomi, K., Saito, C., Nagai, K. et al. Ratio of serum creatinine to cystatin C is related to leg strength in predialysis CKD patients. Clin Exp Nephrol 25, 1079–1086 (2021). https://doi.org/10.1007/s10157-021-02050-7

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