대한신장학회

논문분류	춘계학술대회 초록집
제목	The association between Urine Creatinine Excretion and Arterial Stiffness in Chronic Kidney Disease: KNOW-CKD Study
저자	Young Youl Hyun, Kyu Beck Lee, Kook-Hwan Oh, Curie Ahn, Sue Kyung Park, Joongyub Lee, Dong Wan Chae, Kyu Hun Choi, Yong-Soo Kim, Wookyung Chung, Young-Hwan Hwang, Soo Wan Kim, Yeong Hoon Kim
출판정보	2015; 2015(1):
키워드	소변 크레아티닌 배설량, 근육량, 동맥경직도
초록	Objective: Arterial stiffness measured by PWV (Pulse Wave Velocity) is a predictor of cardiovascular events, cardiovascular and all-cause mortality in patients with hypertension, diabetes and ESRD and even in the general population. Previous studies also have shown that low muscle mass is associated with arterial stiffness in non-CKD (Chronic Kidney Disease) population, and this might be a link between lower muscle mass and worse cardiovascular outcome. However, the association between muscle mass and arterial stiffness in CKD patients is not known. Methods: 1,529 CKD patients were enrolled in the prospective KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) study between 2011~2013. We analyzed 1,017 participants from this cohort who underwent a 24-hr urine collection and brachial-ankle PWV (baPWV) as baseline examination. Mean of right and left baPWV (mPWV) was used as a marker of arterial stiffness. 24-hr urine creatinine excretion (UCr) was used as an estimate of muscle mass. We used multivariate linear regression to analyze the association between UCr and mPWV. Logistic regression analysis was used to estimate the odds ratio for highest quintile of mPWV. Results: Participants were divided into five groups according to their quintile of UCr. mPWV values were different between UCr quintiles (1,639±415, 1,553±369, 1,553±355, 1,484±276 and 1,411±254 for the 1st to 5th quintiles of UCr, p<0.001). Per each 100 mg/d increase in UCr, mPWV decreased by 6 m/sec in multivariable linear regression model fully-adjusted with age, sex, BMI, SBP, diabetes, calcium, phosphorus, eGFR, total cholesterol, log-transformed CRP, statin usage and current smoking status (p=0.022). The odds ratio of 1st quintile for CAC compared with 4th quintile was 2.18 (1.16-4.11, P=0.016) in a logistic model fully-adjusted with age, sex, BMI, hypertension, diabetes, eGFR, calcium, phosphorus, total cholesterol, hsCRP, statin usage and current smoking status. Conclusion: Low muscle mass estimated by low UCR was associated high baPWV in predialysis CKD patients in Korea. Further studies are warranted to verify the causal relationship and the role of muscle mass in the development of cardiovascular disease in CKD patients.
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