title: A Simpler Creatinine Index Can Predict Long-Term Survival in Chinese Hemodialysis Patients.
abstract: BACKGROUND
  Low lean body mass (LBM) is an indicator of malnutrition inflammation syndrome, which is common in hemodialysis (HD) patients. The creatinine index (CI) has been validated as a reliable method to estimate LBM and evaluate the protein-energy status of HD patients. However, the traditional creatinine index formula was complex. We sought to investigate the impact of CI derived from a new simple formula on Chinese HD patient outcomes.
  
  
  METHODS
  In this retrospective cohort study, we enrolled 1269 patients who initiated HD between February 1981 and February 2012 and followed them until the end of February 2013. CI was calculated using the simple creatinine kinetic model (CKM) formula. Multiple linear regression analysis and Cox regression proportional hazard analysis were used to define independent variables and compare survival between groups.
  
  
  RESULTS
  The 1269 HD patients were categorized into 3 groups according to the tertiles of calculated CI between men and women. Each group consisted of 423 patients (50.6% men, 49.4% women). Patients in the highest sex-specific tertile of CI had longer overall survival (HR, 0.46; P 0.002). BMI did not significantly associate with survival after adjustment (HR,0.99; P 0.613).
  
  
  CONCLUSIONS
  CI derived from the simple CKM formula serves as a good parameter than BMI to predict the survival of HD patients. The formula could extend its convenient use in clinical practice for HD patients.
authors: Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan.
authors: Chiung-Ying
authors: http://orcid.org/0000-0003-1285-089X
authors: CY
authors: Huang
authors: Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan.
authors: Szu-Ying
authors: SY
authors: Lee
authors: Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Hsin-Chu Branch, Hsin Chu City, Taiwan.
authors: Chung-Wei
authors: CW
authors: Yang
authors: Division of Nephrology, Taipei Tzu Chi Hospital, New Taipei City, Taiwan.
authors: Szu-Chun
authors: SC
authors: Hung
authors: Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors: Chih-Kang
authors: CK
authors: Chiang
authors: Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors: Jenq-Wen
authors: JW
authors: Huang
authors: Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.
authors: Kuan-Yu
authors: KY
authors: Hung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D003404:Creatinine / Q000378:metabolism*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D003404:Creatinine