Sarcopenia as the reason of hypodiagnostics of chronic kidney disease in patients with chronic heart failure.

• Published in: Advances in gerontology = Uspekhi gerontologii Vol. 33; no. 1; p. 121
• Main Authors: Gulyaev, N I, Akhmetshin, I M, Gordienco, A V, Yakovlev, V V
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2020
• Subjects: cystatin C; creatinine; glomerular filtration rate; chronic heart failure; sarcopenia
• ISSN: 1561-9125

The purpose of the research is comparison of glomerular filtration rate calculated on the basis of serum concentrations of creatinine and cystatin C in patients with chronic heart failure and sarcopenia. In this research 86 patients with chronic heart failure and sarcopenia aged 60 to 92 years (mean age 75±7 years) were examined. GFR calculation was determined using formulas based on creatinine (CKD-EPIC), cystatin C (CKD-EPICys) in blood and both markers (CKD-EPICr-Cys). The concentration of cystatin C in blood serum was determined by the immunoturbidimetric method, and creatinine by the Jaffe kinetic method. Composite body composition was studied in all patients using dual-energy X-ray absorptiometry with calculation of the sarcopenia index (according to FNIH criteria, 2014) and measurement of total fat mass. A test with a 6-minute walk, an assessment according to the SHOKS scale (clinical condition assessment scale for CHF), transthoracic echocardiography with the measurement of EDD, ESD, LVEF, LVМ, LVIM, indicators of LV diastolic function was performed. Depending on the diagnostic criteria for sarcopenia, patients were divided into 2 groups: the first - a combination of heart failure and sarcopenia; the second - CHF without sarcopenia. In patients with CHF and sarcopenia, GFR was reassessed as calculated by the creatinine level by 23% (the absolute difference is more than 18 ml/min/1,73 m2) compared with GFR estimated by the level of cystatin C. In patients with heart failure and sarcopenia, when using a serum concentration of creatinine, there is a hypodiagnostics of the severity of chronic kidney disease. In this regard, if there are signs of sarcopenia, it is recommended to use the formula CKD-EPICys to calculate GFR.