Effect of residual renal function on creatinine index in hemodialysis patients and its pathophysiological significance

Abstract

Objective: This study aimed to explore the relationship between the modified creatinine index (mCI) and handgrip strength, and that with nutritional indicators, as well as assess the effect of the residual renal function on mCI. Methods: A total of 107 outpatients undergoing hemodialysis were included, with a mean age of 68.6 years and an average dialysis duration of 12.1 years. Correlations between mCI and handgrip strength, albumin (ALB), body mass index (BMI), geriatric nutritional risk index (GNRI), normalized protein catabolic rate (nPCR), and creatinine generation rate (％CGR) were evaluated. Patients were divided into two groups based on their residual renal function: those with a dialysis history of more or less than 5 years, and their indices were compared. Results: mCI demonstrated significant positive correlations with handgrip strength (r＝0.62), GNRI (r＝0.52), ALB (r＝0.44), BMI (r＝0.37), nPCR (r＝0.42), and ％CGR (r＝0.65), all with p ＜0.001. Comparisons between the groups showed that mCI, nPCR, and ％CGR were significantly lower (p＜0.01) in patients with a residual renal function. Care‒dependent patients were predominant in the group with mCI, handgrip strength, and GNRI all below their respective cutoff values. Conclusion: mCI may serve as an indicator of skeletal muscle mass in hemodialysis patients; however, the impact of any residual renal function should be taken into consideration.