A Simpler Creatinine Index Can Predict Long-Term Survival in Chinese Hemodialysis Patients

• Published in: PloS one 2016-10, Vol.11 (10), p.e0165164-e0165164
• Main Authors: Huang, Chiung-Ying, Lee, Szu-Ying, Yang, Chung-Wei, Hung, Szu-Chun, Chiang, Chih-Kang, Huang, Jenq-Wen, Hung, Kuan-Yu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Asian Continental Ancestry Group; Biology and Life Sciences; Body fat; Body mass; Body Mass Index; Body size; Clinical medicine; Councils; Creatinine; Creatinine - metabolism; Diabetes; Dialysis; Energy balance; Female; Hazard assessment; Hemodialysis; Hospitals; Humans; Independent variables; Internal medicine; Kidney diseases; Kidney Failure, Chronic - metabolism; Kidney Failure, Chronic - therapy; Laboratories; Lean body mass; Male; Malnutrition; Medical prognosis; Medical records; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Nephrology; Nutrition; Patients; People and Places; Peritoneal dialysis; Prognosis; Proteins; Regression Analysis; Renal Dialysis - adverse effects; Retrospective Studies; Survival; Survival Analysis; Transplants & implants; Treatment Outcome; Variables
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0165164

Low lean body mass (LBM) is an indicator of malnutrition inflammation syndrome, which is common in hemodialysis (HD) patients. The creatinine index (CI) has been validated as a reliable method to estimate LBM and evaluate the protein-energy status of HD patients. However, the traditional creatinine index formula was complex. We sought to investigate the impact of CI derived from a new simple formula on Chinese HD patient outcomes. In this retrospective cohort study, we enrolled 1269 patients who initiated HD between February 1981 and February 2012 and followed them until the end of February 2013. CI was calculated using the simple creatinine kinetic model (CKM) formula. Multiple linear regression analysis and Cox regression proportional hazard analysis were used to define independent variables and compare survival between groups. The 1269 HD patients were categorized into 3 groups according to the tertiles of calculated CI between men and women. Each group consisted of 423 patients (50.6% men, 49.4% women). Patients in the highest sex-specific tertile of CI had longer overall survival (HR, 0.46; P 0.002). BMI did not significantly associate with survival after adjustment (HR,0.99; P 0.613). CI derived from the simple CKM formula serves as a good parameter than BMI to predict the survival of HD patients. The formula could extend its convenient use in clinical practice for HD patients.