title: Association between Urine Creatinine Excretion and Arterial Stiffness in Chronic Kidney Disease: Data from the KNOW-CKD Study.
abstract: OBJECTIVE
  Previous studies have shown that low muscle mass is associated with arterial stiffness, as measured by pulse wave velocity (PWV), in a population without chronic kidney disease (CKD). This link between low muscle mass and arterial stiffness may explain why patients with CKD have poor cardiovascular outcomes. However, the association between muscle mass and arterial stiffness in CKD patients is not well known.
  
  
  METHODS
  Between 2011 and 2013, 1,529 CKD patients were enrolled in the prospective Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). We analyzed 888 participants from this cohort who underwent measurements of 24-hr urinary creatinine excretion (UCr) and brachial-ankle PWV (baPWV) at baseline examination. The mean of the right and left baPWV (mPWV) was used as a marker of arterial stiffness.
  
  
  RESULTS
  The baPWV values varied according to the UCr quartile (1,630±412, 1,544±387, 1,527±282 and 1,406±246 for the 1st to 4th quartiles of UCr, respectively, P<0.001). For each 100 mg/d increase in UCr, baPWV decreased by 6m/sec in a multivariable linear regression model fully adjusted for traditional and renal cardiovascular risk factors. The odds ratio of the 1st quartile for high baPWV (highest quintile of mPWV) compared with the 4th quartile was 2.62 (1.24-5.54, P=0.011) in a logistic model fully adjusted for traditional and renal cardiovascular risk factors.
  
  
  CONCLUSIONS
  Low muscle mass estimated by low UCr was associated high baPWV in pre-dialysis CKD patients in Korea. Further studies are needed to confirm the causal relationship between UCR and baPWV, and the role of muscle mass in the development of cardiovascular disease in CKD.
authors.affiliation: Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
authors.forename: Young Youl
authors.initials: YY
authors.lastname: Hyun
authors.forename: Hyang
authors.initials: H
authors.lastname: Kim
authors.forename: Su-Ah
authors.initials: SA
authors.lastname: Sung
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Chae
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Kyu Hun
authors.initials: KH
authors.lastname: Choi
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
authors.forename: Kyu-Beck
authors.initials: KB
authors.lastname: Lee
mesh_terms: D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000652:urine; D056910:Republic of Korea; D059289:Vascular Stiffness
chemical_list: D003404:Creatinine