Serum creatinine to cystatin C ratio and clinical outcomes in adults with non-dialysis chronic kidney diseaseopen access
- Authors
- Hyun, Young Youl; Lee, Kyu-Beck; Kim, Hyoungnae; Kim, Yaeni; Chung, Wookyung; Park, Hayne Cho; Han, Seung Hyeok; Oh, Yun Kyu; Park, Sue Kyung; Oh, Kook-Hwan
- Issue Date
- Sep-2022
- Publisher
- Frontiers Media S.A.
- Keywords
- creatinine; cystatin C ratio; death; cardiovascular events; chronic kidney disease; muscle wasting
- Citation
- Frontiers in Nutrition, v.9
- Journal Title
- Frontiers in Nutrition
- Volume
- 9
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21800
- DOI
- 10.3389/fnut.2022.996674
- ISSN
- 2296-861X
- Abstract
- BackgroundStudies have suggested that the serum creatinine/cystatin C (Cr/CysC) ratio is a surrogate marker for muscle wasting is associated with adverse outcomes in several disease conditions. To clarify the utility of the Cr/CysC ratio as a prognostic marker in chronic kidney disease (CKD) we evaluated the association between the Cr/CysC ratio clinical outcomes in patients with non-dialysis CKD. MethodsThis prospective observational cohort study included 1,966 participants of the KoreaN cohort study Outcomes in patients With CKD (KNOW-CKD). We evaluated associated factors with the serum Cr/CysC ratio and association between the serum Cr/CysC ratio and composite outcomes of all-cause death and cardiovascular events (CVEs). ResultsThe mean age was 54 +/- 12 (SD) years and 61% were men. The mean serum Cr/CysC ratio was 10.97 +/- 1.94 in men and 9.10 +/- 1.77 in women. The Cr/CysC ratio correlated positively with urinary creatinine excretion, a marker of muscle mass. In the fully adjusted Cox proportional hazard model, the Cr/CysC ratio was associated with the occurrence of adverse outcomes through a median follow-up of 5.9 years [hazard ratio (HR) = 0.92, 95% confidence interval (CI) = 0.85-0.99 for the composite outcomes, HR = 0.87, 95% CI, 0.78 - 0.97 for all-cause death, and HR = 0.93; 95% CI, 0.84-1.04 for CVEs]. In subgroup analyses, there were interactions of the Cr/CysC ratio with age and sex for risk of the clinical outcomes, but not eGFR group. ConclusionA higher Cr/CysC ratio is associated with a lower risk of the composite outcomes, especially all-cause mortality, even after adjusting for eGFR. These suggest that the Cr/CysC ratio is a useful prognostic marker in CKD.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21800)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.