Abstract
Renal dysfunction and sarcopenia are important prognostic factors in patients with chronic liver disease (CLD). Muscle atrophy can cause the overestimation of renal function based on serum creatinine. However, the frequency of overestimated renal function in Japanese patients with CLD and its relationship with sarcopenia are unclear. In present study, we evaluated the frequency of overestimated renal function, defined as a >20% higher eGFR using creatinine than using cystatin C, in 307 patients with CLD as well as its relationship with indicators of sarcopenia. In total, 24.8% of patients had overestimated renal function. In a multivariate regression analysis, liver cirrhosis (p = 0.004) and psoas muscle mass index (p = 0.049) were significantly associated with overestimated renal function. Loss of skeletal muscle mass was significantly more frequent in both male and female patients with overestimated renal function than without. In males, the loss of muscle strength and rate of sarcopenia, defined as loss of muscle mass and strength, were significantly higher in patients with than without overestimated renal function. The high frequency of overestimated renal function in Japanese patients suggests that indicators of renal function should be carefully considered; furthermore, monitoring and interventions for both renal function and sarcopenia are needed in patients with CLD.
Highlights
IntroductionIn patients with chronic liver disease (CLD), renal dysfunction [1,2], and sarcopenia [3,4,5]
We analyzed the frequency of overestimated renal function in Japanese patients with chronic liver disease (CLD) and the relationship between overestimated renal function, loss of skeletal muscle, and sarcopenia
A multivariate analysis of clinical factors revealed that LC and psoas muscle mass index (PMI) values were significantly associated with overestimated renal function, consistent with the results of a previous study [13]
Summary
In patients with chronic liver disease (CLD), renal dysfunction [1,2], and sarcopenia [3,4,5]. Are important independent prognostic factors; the analysis of the prevalence and characteristics of patients with renal dysfunction or sarcopenia is a clinically important issue. Primary sarcopenia, defined as age-related skeletal muscle mass atrophy and loss of muscle strength, has a poor prognosis [6,7,8]. The Japan Society of Hepatology (JSH) guidelines [10] recommend the diagnosis of sarcopenia in liver disease by measuring muscle strength and skeletal muscle mass. The presence of sarcopenia in patients with CLD is associated with a poor anticancer treatment response [11] and poor prognosis [3]
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