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The following is a summary of “Creatinine clearance/eGFR ratio: a simple index for muscle mass related to mortality in ICU patients,” published in the October 2024 issue of Nephrology by Volbeda et al. 

In people in the ICU, muscle mass is inversely associated with mortality. 

Researchers conducted a retrospective study assessing the association of the measured creatinine clearance (mCC) to estimated glomerular filtration rate (eGFR) ratio with all-cause patients’ mortality in ICU. 

They calculated the mCC from urinary creatinine excretion (UCE) and plasma creatinine, then indexed it to 1.73 m² of body surface area. The mCC to eGFR ratio was determined in patients admitted to the ICU (2005 and 2021) with kidney disease, Improving Global Outcomes acute kidney injury (AKI) stage 0-2 and an ICU stay of at least 24 hours. 

The results showed 7,509 patients (mean age 61 ± 15 years; 38% female). In-hospital mortality was 27% in the lowest mCC/eGFR quartile compared to 11% in the highest quartile (P<0.001), 5 year post-hospital discharge actuarial mortality was 37% in the lowest mCC/eGFR quartile compared to 19% in the highest quartile (P<0.001). The mCC/eGFR ratio as a continuous variable was independently associated with in-hospital mortality in multivariable logistic regression (OR: 0.578 [95% CI: 0.465—0.719]; P<0.001). The mCC/eGFR ratio as a continuous variable was also significantly associated with 5-year post-hospital discharge mortality in Cox regression (HR: 0.27 [95% CI: 0.22—0.32]; P<0.001). 

They concluded that the measured creatinine clearance to estimated GF rate ratio was associated with in-hospital and long-term patients mortality in ICU and may serve as an accessible index of muscle mass. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03760-2