Bioelectrical impedance can be used to predict muscle mass and hence improve estimation of glomerular filtration rate in non-diabetic patients with chronic kidney disease

Abstract

ALM(BIA) provides a clinically obtainable and valid method to predict muscle mass in patients with CKD, and using ALM(BIA) improves the estimation of GFR(inu). Researchers developing future GFR estimation equations should consider including ALM(BIA).

Relationship between Body Composition and Glomerular Filtration Rate Estimates in the General Population

“…Considering prior studies in CKD patients [10,11], our results are plausible but the magnitude of the effect needs to be examined in future investigations. While the homogeneity of the subjects may be considered a strength of the study, it may also limit the generalizability of our findings.…”

“…Another study carried out in Sweden [9] showed an improvement in the accuracy of eGFR when calculated lean mass was included in the prediction equation. None of these studies have employed the CKD-EPI equation and are limited to relatively small groups of patients or special populations [5,6,7,8,9,10,11,12]. Our study suggests that body composition may also be of importance in the general population but the effect may be of lesser magnitude than in these selected populations.…”

“…Several previously published studies on the relationship between muscle mass and measured GFR suggest that lean mass might influence eGFR when calculated using the MDRD equation [5,6,7,8,9,10,11,12]. For example, Macdonald et al [10] found that in non-diabetic CKD patients appendicular lean mass index explained an additional 10% of the variability in measured GFR after adjusting for creatinine, age and gender.…”

“…Nevertheless, when compared to measured GFR, the performance of both equations has been shown to be minimally affected by basic anthropometric measures such as body mass index (BMI) [3,4], suggesting that age, gender and race may be adequate surrogate markers for body composition. However, small studies in certain patient populations indicate that lean body mass should be taken into account when estimating GFR using the MDRD equation [5,6,7,8,9,10,11,12]. Thus, the failure of GFR estimating equations to adequately adjust for variations in muscle mass may lead to misdiagnosis and misclassification of CKD.…”

Association between Cigarette Smoking and Chronic Kidney Disease in Japanese Men

“…Because the serum creatinine value is the balance of the release from skeletal muscle and removal by the kidneys, both muscle mass and renal function are important determinants. Recent studies have shown that anthropometric/demographic variables, such as age, gender, height, and weight, may not adequately account for variance in muscle mass, and that measures of muscle mass, which can be clinically obtainable (24), may improve the estimation of GFR (25). Third, owing to the cross-sectional nature of the current study, we cannot determine whether or not elevation of eGFR in smokers modulates long-term renal prognosis.…”