Key result
Low urinary creatinine excretion is linked to ~2.6-fold higher arterial stiffness risk in pre-dialysis CKD.
Why the study?
The association between muscle mass and arterial stiffness in patients with chronic kidney disease is not well known.
Is low muscle mass (estimated by low 24-hr urinary creatinine excretion) associated with increased arterial stiffness in pre-dialysis CKD patients?
Cohort (n=888)
Is low muscle mass (estimated by low 24-hr urinary creatinine excretion) associated with increased arterial stiffness in pre-dialysis CKD patients?
Odds Ratio: 2.62 (95% CI 1.24–5.54)
p-value: p=0.011
Low muscle mass, estimated by low urinary creatinine excretion, is significantly associated with increased arterial stiffness in pre-dialysis CKD patients.
Should not yet change practice in pre-dialysis CKD; hypothesis-generating for muscle mass as a vascular risk factor requiring prospective confirmation.
BACKGROUND/AIMS: Previous studies have shown that low muscle mass is associated with arterial stiffness, as measured by pulse wave velocity (PWV), in a population without chronic kidney disease (CKD). This link between low muscle mass and arterial stiffness may explain why patients with CKD have poor cardiovascular outcomes. However, the association between muscle mass and arterial stiffness in CKD patients is not well known. METHODS: Between 2011 and 2013, 1,529 CKD patients were enrolled in the prospective Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). We analyzed 888 participants from this cohort who underwent measurements of 24-hr urinary creatinine excretion (UCr) and brachial-ankle PWV (baPWV) at baseline examination. The mean of the right and left baPWV (mPWV) was used as a marker of arterial stiffness. RESULTS: The baPWV values varied according to the UCr quartile (1,630±412, 1,544±387, 1,527±282 and 1,406±246 for the 1st to 4th quartiles of UCr, respectively, P<0.001). For each 100 mg/d increase in UCr, baPWV decreased by 6m/sec in a multivariable linear regression model fully adjusted for traditional and renal cardiovascular risk factors. The odds ratio of the 1st quartile for high baPWV (highest quintile of mPWV) compared with the 4th quartile was 2.62 (1.24-5.54, P=0.011) in a logistic model fully adjusted for traditional and renal cardiovascular risk factors. CONCLUSION: Low muscle mass estimated by low UCr was associated high baPWV in pre-dialysis CKD patients in Korea. Further studies are needed to confirm the causal relationship between UCR and baPWV, and the role of muscle mass in the development of cardiovascular disease in CKD.
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Hyun et al. (2016) conducted a cohort in Chronic Kidney Disease (n=888). Low 24-hour urinary creatinine excretion (1st quartile) vs. High 24-hour urinary creatinine excretion (4th quartile) was evaluated on High brachial-ankle pulse wave velocity (highest quintile of mPWV) (OR 2.62, 95% CI 1.24-5.54, p=0.011). Low 24-hour urinary creatinine excretion was significantly associated with high arterial stiffness in pre-dialysis CKD patients (OR 2.62; 95% CI 1.24-5.54; P=0.011).
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