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Kidney Week

Abstract: PO2335

Estimated Glomerular Filtration Rate Equations Based on Cystatin C Are Determined by Bioimpedance-Retrieved Fat Mass Index in Swedish Adults

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Laucyte-Cibulskiene, Agne, Lunds Universitet, Lund, Sweden
  • Christensson, Anders, Lunds Universitet, Lund, Sweden
Background

The growing burden of obesity and its associations with chronic kidney disease (CKD) is becoming a hot topic for nephrologist. CystatinC, a marker of kidney function, tends to be increased in obesity. We hypothesize that bioimpedance acquired fat mass index acquired is associated with estimated glomerular filtration rate (eGFR) based on cystatinC.

Methods

5061 subjects, born 1926-45, were selected from the population based Malmö Diet and Cancer cohort (MDC CC). They underwent body composition analysis (BIA-103 RJL system) and biochemistry during the year 1991-95. Men and women were divided into 3 groups according calculated fat mass index z-score (FMIz): low(<-1), middle(>-1,<1), high(>1). eGFR calculated using 4 equations: Chronic Kidney Disease Epidemiology Collaboration 2012 (CKD-EPI creatinine, CKD-EPI cystatinC), cystatinC eGFR based on Caucasian, Asian, pediatric, and adult cohorts (CAPA), the Lund-Malmö revised creatinine equation (LMrev).

Results

CystatinC correlated with fat weight (kg), FMI and FMIz in both sexes, meanwhile creatinine was not associated with muscle mass. Significant sex difference observed in high FMIz group revealing lower CAPA and lower CKD-EPI cystatin C values in women and no differences in creatinine based eGFR both in men and women (Fig.1). Women with high FMIz tended to have higher body mass index compared to men (p<0.001) and no age difference. Muscle mass remained almost unchanged in FMIz groups in both sexes.

Conclusion

The correlation between cystatinC and fat weight may be due to several reasons. Obesity induced CKD is one. Further studies are warranted to exclude that cystatinC originates from adipose tissue. The use of cystatinC eGFR equations should be used with caution in obese individuals, especially in women.

Fig.1 Kidney function calculated by different estimated glomerular filtration rate equations with regadrs to sex and fat mass index z-score group