The value of spot urinary creatinine as a marker of muscle wasting in patients with new‐onset or worsening heart failure

Background Muscle wasting and unintentional weight loss (cachexia) have been associated with worse outcomes in heart failure (HF), but timely identification of these adverse phenomena is difficult. Spot urinary creatinine may be an easily accessible marker to assess muscle loss and cachexia. This st...

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Bibliographic Details
Published in:Journal of cachexia, sarcopenia and muscle sarcopenia and muscle, 2021-06, Vol.12 (3), p.555-567
Main Authors: Pandhi, Paloma, Streng, Koen W., Anker, Stefan D., Cleland, John G., Damman, Kevin, Dickstein, Kenneth, Pellicori, Pierpaolo, Lang, Chim C., Ng, Leong, Samani, Nilesh J., Zannad, Faiez, Metra, Marco, Rossignol, Patrick, Filippatos, Gerasimos, Veldhuisen, Dirk J., Voors, Adriaan A., Maaten, Jozine M.
Format: Article
Language:English
Subjects:
Acute heart failure
Cardiology and cardiovascular system
Cardiovascular disease
Chronic illnesses
Creatinine
Diuretics
Edema
Exercise
Heart failure
Human health and pathology
Laboratories
Life Sciences
Mortality
Muscle wasting
Original
Peptides
Physical fitness
Regression analysis
Urinary creatinine
Variance analysis
Weight loss
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Summary:Background Muscle wasting and unintentional weight loss (cachexia) have been associated with worse outcomes in heart failure (HF), but timely identification of these adverse phenomena is difficult. Spot urinary creatinine may be an easily accessible marker to assess muscle loss and cachexia. This study investigated the association of urinary creatinine with body composition changes and outcomes in patients with new‐onset or worsening HF (WHF). Methods In BIOSTAT‐CHF, baseline spot urinary creatinine measurements were available in 2315 patients with new‐onset or WHF in an international cohort (index cohort) and a validation cohort of 1431 similar patients from Scotland. Results Median spot urinary creatinine concentrations were 5.2 [2.7–9.6] mmol/L in the index cohort. Median age was 69 ± 12 years and 73% were men. Lower spot urinary creatinine was associated with older age, lower height and weight, worse renal function, more severe HF, and a higher risk of >5% weight loss from baseline to 9 months (odds ratio = 1.23, 95% CI = 1.09–1.39 per log decrease; P = 0.001). Spot urinary creatinine was associated with Evans criteria of cachexia (OR = 1.26 per log decrease, 95% CI = 1.04–1.49; P = 0.016) and clustered with markers of heart failure severity in hierarchical cluster analyses. Lower urinary creatinine was associated with poorer exercise capacity and quality of life (both P 
ISSN:2190-5991
2190-6009
DOI:10.1002/jcsm.12690