Dataset Information

Decreased serum creatinine levels predict short survival in amyotrophic lateral sclerosis.

ABSTRACT:

Objective

To explore the associations between serum creatinine and creatine kinase (CK) levels with survival in male and female ALS patients.

Methods

A prospective cohort study was carried out including 346 ALS patients with repeated serum creatinine and CK measurements. Kaplan Meier analysis and multivariable Cox regression were used to perform survival analysis.

Results

There were 218 male and 128 female patients, and the males had significantly higher baseline serum creatinine and CK levels than females. After multivariable Cox regression analysis, lower baseline serum creatinine levels were associated with a short survival in both male (?61 ?mol/L, HR: 1.629; 95%CI: 1.168-2.273) and female ALS patients (?52 ?mol/L, HR: 1.677; 95%CI: 1.042-2.699), whereas, the serum CK levels were not correlated with survival. Besides, creatinine levels were positively associated with ALSFRS-R scores, and inversely with the decline rate of ALSFRS-R per month. During follow-up, serum creatinine levels tended to be decreased along with the disease progression, and the higher decline rate of creatinine per month (>1.5) showed significantly shorter survival, compared to the lower group (?1.5) (30.0 months vs. 65.0 months, Chi square = 28.25, P < 0.0001).

Interpretation

Serum creatinine could be a reliable and easily accessible prognostic chemical marker for ALS, and decreased baseline creatinine levels could predict a poor prognosis and a short survival in both male and female ALS patients.

SUBMITTER: Guo QF

PROVIDER: S-EPMC7886033 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Decreased serum creatinine levels predict short survival in amyotrophic lateral sclerosis.

Guo Qi-Fu QF Hu Wei W Xu Liu-Qing LQ Luo Hao H Wang Ning N Zhang Qi-Jie QJ

Annals of clinical and translational neurology 20210115 2

<h4>Objective</h4>To explore the associations between serum creatinine and creatine kinase (CK) levels with survival in male and female ALS patients.<h4>Methods</h4>A prospective cohort study was carried out including 346 ALS patients with repeated serum creatinine and CK measurements. Kaplan Meier analysis and multivariable Cox regression were used to perform survival analysis.<h4>Results</h4>There were 218 male and 128 female patients, and the males had significantly higher baseline serum crea ...[more]

PMID: 33449454

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Project description:Serum creatinine and C-reactive protein have been proposed as potential biomarkers for neurodegenerative diseases, including amyotrophic lateral sclerosis, multiple sclerosis and Parkinson's disease. However, longitudinal studies investigating temporal patterns of these biomarkers, including the phase before diagnosis, are rare. We performed a case-control study including all newly diagnosed patients with amyotrophic lateral sclerosis (N = 525), multiple sclerosis (N = 1815) or Parkinson's disease (N = 3797) during 2006-2013 in Stockholm, Sweden, who participated in the Stockholm CREAtinine Measurements (SCREAM) project. For each case, we randomly selected up to five controls from SCREAM that were individually matched to the case by age, sex and county of residence (N = 2625 for amyotrophic lateral sclerosis, N = 9063 for multiple sclerosis and 18 960 for Parkinson's disease). We collected for both the cases and the controls testing results of serum creatinine and C-reactive protein performed by healthcare providers in Stockholm during the study period. Median levels of creatinine and C-reactive protein were visualized using locally weighted smoothing curves among cases and controls. A linear mixed model was also applied to explore temporal changes within an individual. Compared to controls, patients with amyotrophic lateral sclerosis had lower levels of creatinine from 2 years before diagnosis onwards. In contrast, patients with amyotrophic lateral sclerosis had lower levels of C-reactive protein before diagnosis but higher levels after diagnosis, compared to controls. Focusing the 2 years before to 2 years after diagnosis, patients with amyotrophic lateral sclerosis displayed statistically significantly decreasing level of creatinine from 1 year before diagnosis until 2 years after diagnosis, whereas increasing level of C-reactive protein from diagnosis until 2 years after diagnosis. There were no similar patterns noted among patients with multiple sclerosis or Parkinson's disease, or the controls of the three patient groups. Patients with amyotrophic lateral sclerosis display distinct temporal patterns of creatinine and C-reactive protein before and after diagnosis, compared to amyotrophic lateral sclerosis-free controls or patients with multiple sclerosis and Parkinson's disease.

Dataset Information

Decreased serum creatinine levels predict short survival in amyotrophic lateral sclerosis.

Objective

Methods

Results

Interpretation

Publications

Decreased serum creatinine levels predict short survival in amyotrophic lateral sclerosis.

Similar Datasets

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