Low Serum Creatine Kinase Level Predicts Mortality in Patients with a Chronic Kidney Disease

Abstract

BackgroundSerum creatine kinase (sCK) reflects CK activity from striated skeletal muscle. Muscle wasting is a risk factor for mortality in patients with chronic kidney disease (CKD). The aim of this study is to evaluate whether sCK is a predictor of mortality and end-stage renal disease (ESRD) in a CKD population.MethodsWe included 1801 non-dialysis-dependent CKD patients from the NephroTest cohort. We used time-fixed and time-dependent cause-specific Cox models to estimate hazard ratios (HRs) for the risk of death and for the risk of ESRD associated with gender-specific sCK tertiles.ResultsHigher sCK level at baseline was associated with a lower age, a higher body mass index, and a higher level of 24 h urinary creatinine excretion, serum albumin and prealbumin (p<0.001). Men, patients of sub-Saharan ancestry, smokers and statin users also experienced a higher level of sCK. In a time-fixed Cox survival model (median follow-up 6.0 years), the lowest gender-specific sCK tertile was associated with a higher risk of death before and after adjustment for confounders (Crude model: hazard ratio (HR) 1.77 (95% CI: 1.34–2.32) compared to the highest tertile; fully-adjusted model: HR 1.37 (95% CI: 1.02–1.86)). Similar results were obtained with a time-dependent Cox model. The sCK level was not associated with the risk of ESRD.ConclusionA low level of sCK is associated with an increased risk of death in a CKD population. sCK levels might reflect muscle mass and nutritional status.

Son Dönem Böbrek Yetmezliği Hastalarinda Serum Kreatin Kinaz (Ck) Düzeyi Malnutrisyon Parametresi Olabilir Mi?

“…When the correlation of serum CK levels with BIA data in HD and PD patient group was examined in the present study, it was determined that they had a positive statistically significant correlation with the variables such as BMI, BFR, lean body mass and body muscle mass (p<0.001) and a negative statistically significant correlation with TBW (p<0.001) in both patient populations. In the literature, Flahault et al, (2016) assessed retrospectively 1801 chronic kidney patients not undergoing dialysis in their study, where they stated that serum CK level had a significant correlation with BMI and muscle mass and that it may reflect the nutritional situation (8). In the present study, it was revealed that serum CK level was correlated with the parameters in BIA method that has been increasingly used recently, which is compatible with the literature.…”

“…In the present study, a positive statistically significant correlation was determined between serum CK levels and albumin in HD and PD patient groups (p<0.001). Similar to the present study, in their study Flahault et al, (2016) determined the existence of a positive statistically significant correlation between serum CK levels and albumin (8).…”

“…Serum creatine kinase (CK) level is used in clinical practice in the diagnosis and follow-up of muscle-related diseases such as rhabdomyolysis, myocardial infarction, myositis and muscular dystrophy (8). CK enzyme that keeps the cell energy balance and have a key role in energy flow is closely associated with the parameters, reflecting the muscle mass directly, such as BMI and lean body mass, which are the known indicators of muscle mass in an organism (9).…”

Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis

“…Nevertheless, our study documented a possible overestimation of renal function by more than 20% with eGFR-Cr in about 19% of RA patients, which was likely attributable to the presence of myopenia/sarcopenia. Flahault et al (23) reported that low serum CK levels in CKD patients reflected loss of muscle mass and malnutrition and were associated with high mortality. In our study, low CK was found to be an independent factor relevant to Group A.…”

Comparative studies of the expression of creatine kinase isoforms under immune stress in Pelodiscus sinensis

“…CK isoenzymes also play important roles directly related to the occurrence of various diseases. For instance, a low level of CK in serum is associated with an increased risk of death in chronic kidney disease [10] and a significant decrease in the serum ubiquitous CK-Mt activity in Parkinson's disease patients [11]. In infectious diseases, CK was detected as upregulated in severe acute respiratory syndrome (SARS) [12], and was also found to be increased in corona virus disease 2019 (COVID-19) [13].…”