Abstract
Background and aims: The modified creatinine (Cr) index, calculated by age, sex, pre-dialysis serum Cr levels, and Kt/V for urea, reflects skeletal muscle mass in patients on hemodialysis. Whether the modified Cr index is associated with cardiovascular events and all-cause mortality remains unknown. Methods: A total of 3027 patients registered in the Q-Cohort Study, a multicenter, prospective study of patients on hemodialysis in Japan, were analyzed. The main outcomes were cardiovascular events and all-cause mortality. Associations between sex-specific quartiles of the modified Cr index and outcomes were analyzed by the Cox proportional hazard models and the Fine–Gray proportional subdistribution hazards model. Results: The modified Cr index was correlated with known nutritional and inflammatory markers. During a 4-year follow-up, 499 patients died of any cause, 372 experienced heart disease, and 194 developed stroke. The risk for all-cause mortality was significantly higher in the lower quartiles (Q1 and Q2) than in the highest quartile (Q4) as the reference group (hazard ratios and 95% confidence intervals: Q1, 2.65 [1.69–4.25], Q2, 1.92 [1.27–2.94], and Q3, 1.31 [0.87–2.02]). The risk of heart disease was significantly higher in Q1 than in Q4 (hazard ratios and 95% confidence intervals: Q1, 1.64 [1.04–2.61], Q2, 1.34 [0.91–2.00], and Q3, 1.04 [0.71–1.52]). The risk of stroke was not associated with the modified Cr index. Conclusions: A lower modified Cr index is associated with an increased risk for heart disease and all-cause mortality, but not with the risk for stroke in patients on hemodialysis.
| Original language | English |
|---|---|
| Pages (from-to) | 115-123 |
| Number of pages | 9 |
| Journal | Atherosclerosis |
| Volume | 275 |
| DOIs | |
| Publication status | Published - Aug 2018 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Modified creatinine index and risk for cardiovascular events and all-cause mortality in patients undergoing hemodialysis : The Q-Cohort study. / Arase, Hokuto; Yamada, Shunsuke; Yotsueda, Ryusuke; Taniguchi, Masatomo; Yoshida, Hisako; Tokumoto, Masanori; Nakano, Toshiaki; Tsuruya, Kazuhiko; Kitazono, Takanari.
In: Atherosclerosis, Vol. 275, 08.2018, p. 115-123.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Modified creatinine index and risk for cardiovascular events and all-cause mortality in patients undergoing hemodialysis
T2 - The Q-Cohort study
AU - Arase, Hokuto
AU - Yamada, Shunsuke
AU - Yotsueda, Ryusuke
AU - Taniguchi, Masatomo
AU - Yoshida, Hisako
AU - Tokumoto, Masanori
AU - Nakano, Toshiaki
AU - Tsuruya, Kazuhiko
AU - Kitazono, Takanari
PY - 2018/8
Y1 - 2018/8
N2 - Background and aims: The modified creatinine (Cr) index, calculated by age, sex, pre-dialysis serum Cr levels, and Kt/V for urea, reflects skeletal muscle mass in patients on hemodialysis. Whether the modified Cr index is associated with cardiovascular events and all-cause mortality remains unknown. Methods: A total of 3027 patients registered in the Q-Cohort Study, a multicenter, prospective study of patients on hemodialysis in Japan, were analyzed. The main outcomes were cardiovascular events and all-cause mortality. Associations between sex-specific quartiles of the modified Cr index and outcomes were analyzed by the Cox proportional hazard models and the Fine–Gray proportional subdistribution hazards model. Results: The modified Cr index was correlated with known nutritional and inflammatory markers. During a 4-year follow-up, 499 patients died of any cause, 372 experienced heart disease, and 194 developed stroke. The risk for all-cause mortality was significantly higher in the lower quartiles (Q1 and Q2) than in the highest quartile (Q4) as the reference group (hazard ratios and 95% confidence intervals: Q1, 2.65 [1.69–4.25], Q2, 1.92 [1.27–2.94], and Q3, 1.31 [0.87–2.02]). The risk of heart disease was significantly higher in Q1 than in Q4 (hazard ratios and 95% confidence intervals: Q1, 1.64 [1.04–2.61], Q2, 1.34 [0.91–2.00], and Q3, 1.04 [0.71–1.52]). The risk of stroke was not associated with the modified Cr index. Conclusions: A lower modified Cr index is associated with an increased risk for heart disease and all-cause mortality, but not with the risk for stroke in patients on hemodialysis.
AB - Background and aims: The modified creatinine (Cr) index, calculated by age, sex, pre-dialysis serum Cr levels, and Kt/V for urea, reflects skeletal muscle mass in patients on hemodialysis. Whether the modified Cr index is associated with cardiovascular events and all-cause mortality remains unknown. Methods: A total of 3027 patients registered in the Q-Cohort Study, a multicenter, prospective study of patients on hemodialysis in Japan, were analyzed. The main outcomes were cardiovascular events and all-cause mortality. Associations between sex-specific quartiles of the modified Cr index and outcomes were analyzed by the Cox proportional hazard models and the Fine–Gray proportional subdistribution hazards model. Results: The modified Cr index was correlated with known nutritional and inflammatory markers. During a 4-year follow-up, 499 patients died of any cause, 372 experienced heart disease, and 194 developed stroke. The risk for all-cause mortality was significantly higher in the lower quartiles (Q1 and Q2) than in the highest quartile (Q4) as the reference group (hazard ratios and 95% confidence intervals: Q1, 2.65 [1.69–4.25], Q2, 1.92 [1.27–2.94], and Q3, 1.31 [0.87–2.02]). The risk of heart disease was significantly higher in Q1 than in Q4 (hazard ratios and 95% confidence intervals: Q1, 1.64 [1.04–2.61], Q2, 1.34 [0.91–2.00], and Q3, 1.04 [0.71–1.52]). The risk of stroke was not associated with the modified Cr index. Conclusions: A lower modified Cr index is associated with an increased risk for heart disease and all-cause mortality, but not with the risk for stroke in patients on hemodialysis.
UR - http://www.scopus.com/inward/record.url?scp=85048529936&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048529936&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2018.06.001
DO - 10.1016/j.atherosclerosis.2018.06.001
M3 - Article
C2 - 29890446
AN - SCOPUS:85048529936
VL - 275
SP - 115
EP - 123
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
ER -