Dataset Information

Low Serum Creatine Kinase Level Predicts Mortality in Patients with a Chronic Kidney Disease.

ABSTRACT:

Background

Serum creatine kinase (sCK) reflects CK activity from striated skeletal muscle. Muscle wasting is a risk factor for mortality in patients with chronic kidney disease (CKD). The aim of this study is to evaluate whether sCK is a predictor of mortality and end-stage renal disease (ESRD) in a CKD population.

Methods

We included 1801 non-dialysis-dependent CKD patients from the NephroTest cohort. We used time-fixed and time-dependent cause-specific Cox models to estimate hazard ratios (HRs) for the risk of death and for the risk of ESRD associated with gender-specific sCK tertiles.

Results

Higher sCK level at baseline was associated with a lower age, a higher body mass index, and a higher level of 24 h urinary creatinine excretion, serum albumin and prealbumin (p<0.001). Men, patients of sub-Saharan ancestry, smokers and statin users also experienced a higher level of sCK. In a time-fixed Cox survival model (median follow-up 6.0 years), the lowest gender-specific sCK tertile was associated with a higher risk of death before and after adjustment for confounders (Crude model: hazard ratio (HR) 1.77 (95% CI: 1.34-2.32) compared to the highest tertile; fully-adjusted model: HR 1.37 (95% CI: 1.02-1.86)). Similar results were obtained with a time-dependent Cox model. The sCK level was not associated with the risk of ESRD.

Conclusion

A low level of sCK is associated with an increased risk of death in a CKD population. sCK levels might reflect muscle mass and nutritional status.

SUBMITTER: Flahault A

PROVIDER: S-EPMC4889148 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Low Serum Creatine Kinase Level Predicts Mortality in Patients with a Chronic Kidney Disease.

Flahault Adrien A Metzger Marie M Chassé Jean-François JF Haymann Jean-Philippe JP Boffa Jean-Jacques JJ Flamant Martin M Vrtovsnik François F Houillier Pascal P Stengel Bénédicte B Thervet Eric E Pallet Nicolas N

PloS one 20160601 6

<h4>Background</h4>Serum creatine kinase (sCK) reflects CK activity from striated skeletal muscle. Muscle wasting is a risk factor for mortality in patients with chronic kidney disease (CKD). The aim of this study is to evaluate whether sCK is a predictor of mortality and end-stage renal disease (ESRD) in a CKD population.<h4>Methods</h4>We included 1801 non-dialysis-dependent CKD patients from the NephroTest cohort. We used time-fixed and time-dependent cause-specific Cox models to estimate haz ...[more]

PMID: 27248151

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Project description:ObjectivesBody mass index (BMI) is associated with acute kidney injury (AKI) after trauma, but underlying mechanisms are unclear. Body mass index correlates with both excess adiposity and increased muscle mass. Since the latter could predispose to severe rhabdomyolysis after trauma, we hypothesized that the BMI-AKI association may be partially explained by a direct relationship of BMI with serum creatine kinase (CK).MethodsProspective cohort study of 463 critically ill patients admitted to a level I trauma center from 2005 to 2015 with Injury Severity Score of >15 and serum CK measured in the first 7 days. We defined AKI by AKI Network creatinine criteria. We used simple linear regression to determine the association of BMI with peak CK and multivariable logistic regression to adjust the BMI-AKI association for peak CK and confounders.ResultsMedian age was 43 years, 350 (76%) were male, 366 (79%) had blunt mechanism, and median Injury Severity Score was 24. Body mass index was associated with peak CK (R = 0.05, p < 0.001). Acute kidney injury developed in 148 patients (32%), and median time to peak CK was 29 hours (interquartile range, 15-56 hours) after presentation. Body mass index was significantly associated with AKI in multivariable models adjusted for age, race, sex, diabetes, injury mechanism and severity, and red blood cell transfusions (odds ratio [OR], 1.31 per 5 kg/m; 95% confidence interval [CI], 1.09-1.58; p = 0.004). Adding peak CK to the model partially attenuated the association of BMI with AKI (OR, 1.26 per 5 kg/m; 95% CI, 1.04-1.52; p = 0.018), and peak CK was also associated with AKI (OR, 1.19 per natural log; 95% CI, 1.00-1.41; p = 0.049). Peak CK remained associated with AKI when restricted to patients with values of <5,000 U/L (OR, 1.31 per natural log; 95% CI, 1.01-1.69; p = 0.043).ConclusionSerum CK correlated with BMI and partially attenuated the association of BMI with AKI after major trauma, suggesting that excess muscle injury may contribute to the BMI-AKI association.Level of evidenceEpidemiologic study, level III.

Dataset Information

Low Serum Creatine Kinase Level Predicts Mortality in Patients with a Chronic Kidney Disease.

Background

Methods

Results

Conclusion

Publications

Low Serum Creatine Kinase Level Predicts Mortality in Patients with a Chronic Kidney Disease.

Similar Datasets

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