Evidence map›Paper›PMID 33437955›Full record

ArticleEClinicalMedicine2020

How unmeasured muscle mass affects estimated GFR and diagnostic inaccuracy.

Brian J Nankivell, Lachlan F J Nankivell, Grahame J Elder, Simon M Gruenewald

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 3 pooled it
3.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 3 syntheses or guidelines pooled it, 84 citations in OpenAlex.

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  7. Indexing for body surface area when assessing kidney function.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Brian J NankivellDepartments of Renal Medicine, Westmead Hospital, Westmead, Australia.
Lachlan F J NankivellUniversity of Sydney, Australia.
Grahame J ElderDepartments of Renal Medicine, Westmead Hospital, Westmead, Australia.
Simon M GruenewaldUniversity of Sydney, Australia.
The University of Sydney · AUWestmead Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEstimated glomerular filtration (eGFR) results based on serum creatinine are frequently inaccurate with differences against measured GFR (mGFR) often attributed to unmeasured non-functional factors, such as muscle mass.

methodsThe influence of muscle mass (measured by dual-energy x-ray absorptiometry, DEXA) on eGFR error (eGFR-mGFR) was evaluated using isotopic mGFR (Tc

findingsUnindexed CKD-EPI eGFR error displayed absent fixed bias but modest proportional bias against reference mGFR. eGFR error correlated with total lean mass by DEXA (

interpretationSerum creatinine and eGFR are imperfect estimates of true renal function, with systemic errors from muscle mass, tubular secretion, and intrinsic proportional bias; and additional inaccuracy at the extremes of renal function and patient muscularity. Cautious interpretation of eGFR results in the context of body habitus and clinical condition is recommended.

Indexed as

ASMI, appendicular skeletal muscle indexAUC, area under the curveBMI, body mass indexBSA, body surface areaCG, Cockcroft-Gault (eGFR estimated from creatinine clearance)CKD-EPI, Chronic Kidney Disease EPIdemiology (eGFR formula)CV, coefficient of variationDEXADEXA, dual-energy x-ray absorptiometryDiagnostic accuracyeGFReGFR, estimated GFR (implying a creatinine-based formula)GFR, glomerular filtration rateKidney transplantationMDRD, Modification of Diet in Renal Disease (eGFR formula)mGFR, measured GFR (using a reference method)NPV, negative predictive valuePPV, positive predictive valueROC, receiver operating characteristicTc99m DTPA, Technetium-99 m diethylene-triamine-pentaacetic acid

Identifiers

PMID33437955
PMCPMC7788434
OpenAlexW3110136109

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.