Assessment of sarcopenia and malnutrition using estimated GFR ratio (eGFRcys/eGFR) in hospitalised adult patients.

Abstract

The aim of our study was to clarify whether the eGFR ratio (eGFRcys/eGFR) is appropriate for evaluating muscle mass as an alternative method to bioelectrical impedance analysis (BIA). We also investigated the accuracy and usefulness of the eGFR ratio in the diagnosis of sarcopenia and malnutrition. Serum creatinine (Cre) and cystatin C (Cys) were measured, and the eGFR ratio was calculated among 151 hospitalised patients (65 men and 86 women). The correlation between the eGFR ratio and skeletal muscle mass index (SMI) measured using BIA was analysed. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People (EWGSOP) 2 and Asian Working Group for Sarcopenia (AWGS) 2019 algorithms, while malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. The diagnostic accuracy of the calculated SMI (Cal-SMI) based on the eGFR ratio was analysed. A moderate correlation between the eGFR ratio and muscle mass was observed. For the diagnosis of sarcopenia using the EWGSOP2 and Cal-SMI using the eGFR ratio, the sensitivity was 0.952 (95% confidence interval [CI] 0.892-0.984); specificity, 0.848 (95% CI, 0.711-0.937); and diagnostic accuracy, 0.921 (95% CI, 0.865-0.958). For the diagnosis of malnutrition using GLIM, the sensitivity was 0.980 (95% CI 0.929-0.998); specificity, 0.788 (95% CI 0.653-0.889); and diagnostic accuracy, 0.914 (95% CI 0.857-0.953). An accurate diagnosis of sarcopenia using the EWGSOP2 and AWGS2019, and an accurate diagnosis of malnutrition using GLIM, was made using the eGFR ratio. The eGFR ratio may be a suitable alternative when BIA cannot be used.