Evidence map›Paper›PMID 41021368›Full record

ArticleJournal of cachexia, sarcopenia and muscle2025

Impact of Muscle Mass on the Performance of Creatinine-Based eGFR Equations and Mortality Risk Assessment After Kidney Transplantation.

François Gaillard, Melissa Ould Rabah, Olivier Aubert, Nicolas Garcelon, Antoine Neuraz, Christophe Legendre, Dany Anglicheau, Dominique Prié, Frank Bienaimé

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In one paragraph

Article in Journal of cachexia, sarcopenia and muscle, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
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

9 authors.

François GaillardService de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot et Faculté de Médecine, Université Lyon 1, Lyon, France.ORCID 0000-0002-7248-8418
Melissa Ould RabahService de Physiologie, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.ORCID 0000-0003-2315-9738
Olivier AubertFaculté de médecine, Université de Paris-Cité, Paris, France.
Nicolas GarcelonUniversité de Paris, Imagine Institute, Data Science Platform, INSERM UMR 1163, Paris, France.
Antoine NeurazService d'Informatique Médical, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.
Christophe LegendreFaculté de médecine, Université de Paris-Cité, Paris, France.
Dany AnglicheauFaculté de médecine, Université de Paris-Cité, Paris, France.
Dominique PriéService de Physiologie, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.
Frank BienaiméService de Physiologie, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.ORCID 0000-0002-8666-2042

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEstimating glomerular filtration rate (eGFR) in kidney transplant recipients (KTR) typically relies on plasma creatinine, which is influenced by muscle mass. Reduced muscle mass is suspected to reduce eGFR performance in this population but this effect has not been rigorously evaluated. This study quantified the impact of muscle mass on eGFR accuracy and its confounding effect on the association between kidney function and mortality in KTR.

methodsWe studied a prospective and consecutive cohort of 1829 KTR (mean age 52 ± 14 years; 38.9% female) who underwent GFR measurement using iohexol clearance (ioGFR). Muscle mass was assessed by creatinine excretion rate (CER) from timed urine collections. We evaluated the impact of muscle mass on the performance of five eGFR equations (MDRD, CKDEPI

resultsAll eGFR equations showed a significant negative correlation with CER. EKFC was the least sensitive to CER (β coefficient 95% confidence interval [CI]: -0.17 to -0.12). All eGFR equations demonstrated reduced accuracy in the lowest muscle mass tertile. In multivariable analyses, ioGFR was significantly associated with mortality (hazard ratio 95% CI: 0.972-0.995) but eGFRs were not. Including CER in the Cox models resulted in convergence of the mortality hazard ratios for ioGFR and eGFRs (hazard ratio 95% CI: ioGFR: 0.98-0.999; MDRD: 0.98-0.999; CKDEPI

conclusionThe performance of all tested creatinine-based eGFR equations is strongly impacted by muscle mass. Muscle mass is also a key confounder in the mortality risk assessment using eGFR. Incorporating muscle mass into KTR's evaluations may improve kidney function assessments in KTR.

Indexed as

CreatinineGlomerular Filtration RateKidney TransplantationMuscle, SkeletalAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesRisk AssessmentCreatininecreatininekidney transplantation; estimated GFRmeasured GFRmortalitymuscle mass

Identifiers

PMID41021368
PMCPMC12478446

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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.