Coefficient of Determination between Estimated and Measured Renal Function in Japanese Patients with Sarcopenia May Be Improved by Adjusting for Muscle Mass and Sex: A Prospective Study

  • Nakatani Sakura
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University
  • Maeda Keisuke
    Palliative Care Center, Aichi Medical University Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center
  • Akagi Junji
    Department of Surgery, Tamana Regional Health Medical Center
  • Ichigi Misato
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University
  • Murakami Marina
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University
  • Harada Yoshihiko
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University
  • Utsumi Sara
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University
  • Fukunaga Masaki
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University
  • Narita Yuki
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University
  • Kondo Yuki
    Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University
  • Ishitsuka Yoichi
    Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University
  • Irie Tetsumi
    Department of Clinical Chemistry and Informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University
  • Kadowaki Daisuke
    Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Sojo University
  • Hirata Sumio
    Division of Clinical Pharmacology, Center for Clinical Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Kumamoto University

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<p>Creatinine (Cr) levels are strongly affected by muscle mass, and the estimated glomerular filtration rate (eGFR), a measure based on serum creatinine (SCr), is often overestimated in patients with sarcopenia. To evaluate the coefficient of determination (R2) between eGFR and the actual measured value, we performed a linear regression analysis of a modified GFR (mGFR: measured Cr clearance × 0.715) and various renal function estimates adjusted for muscle mass in 19 patients with sarcopenia. The eGFR values based on SCr (eGFRcr) were higher than those based on mGFR, although a high R2 (0.704; p < 0.001) was found between these values. There was no deviation between eGFR based on serum cystatin C (eGFRcys) and mGFR, although the R2 value 0.691 was equivalent to that of eGFRcr. In the equation used to calculate eGFRcr not adjusted for body surface area (mL/min), muscle mass parameters obtained from bioelectrical impedance analysis were used instead of actual body weight to recalculate the eGFRcr. The R2 between this eGFRcr and mGFR did not improve, although there was less deviation. However, assuming that all patients were female by using female coefficients for all patients, the R2 between eGFRcr-fcc (eGFRcr with female coefficient correction) and mGFR improved and was the highest (0.808) on substitution of appendicular skeletal muscle mass. The correlation between eGFRcr-fcc and mGFR improved over eGFRcys when muscle mass was substituted for body weight in the equation used to estimate eGFR in patients with sarcopenia and sex differences were removed.</p>

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