ワカバヤシ　ヒデタカ   Wakabayashi Hidetaka   若林　秀隆    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Elevated Creatinine-Based Estimated Glomerular Filtration Rate is Associated with Increased Risk of Sarcopenia, Dysphagia, and Reduced Functional Recovery after Stroke.
掲載誌名	正式名：Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 略　 称：J Stroke Cerebrovasc Dis ISSNコード：15328511/10523057
掲載区分	国外
巻・号・頁	30(2),pp.105491
著者・共著者	Yoshimura Yoshihiro, Wakabayashi Hidetaka, Nagano Fumihiko, Bise Takahiro, Shimazu Sayuri, Shiraishi Ai
担当区分	2nd著者
発行年月	2020/11
概要	OBJECTIVES:To evaluate the associations between estimated glomerular filtration rate (eGFR) and sarcopenia and functional outcomes after stroke.METHODS:This retrospective cohort study included hospitalized patients after stroke. Data on serum creatinine-based eGFR were extracted from medical records. Primary outcome was the presence of sarcopenia at admission, diagnosed based on both low skeletal muscle mass and strength criteria as per the AWGS 2019. Other outcomes included the Food Intake Level Scale (FILS) score (measure of dysphagia, FILS score <7) at discharge and the Functional Independence Measure-motor (FIM-motor) score at discharge and its change from the baseline. Multivariate analyses were performed to determine the association between eGFR and outcomes.RESULTS:Data from 813 patients (mean age 73.5 years; 51.9% men) were included in the analysis. The median eGFR was 65.1 ml/min/1.73 m2, and about 41% of patients had an eGFR less than 60 ml/min/1.73 m2 at the baseline. Sarcopenia was observed in 47.4% of patients. In the multivariate analyses, baseline eGFR was positively associated with sarcopenia at admission (odds ratio [OR]=1.016, 95% confidence interval [CI]: 1.005-1.027, p = 0.003), the presence of dysphagia at discharge (OR=1.016, 95% CI: 1.001-1.031, p = 0.045), and negatively associated with FIM-motor score at discharge (β= -0.046, p = 0.047) and its gain (β= -0.067, p = 0.037).CONCLUSIONS:Elevated creatinine-based eGFR is associated with sarcopenia, dysphagia, and adverse rehabilitation outcomes after stroke. Our findings highlight the limitations of assessing renal function using creatinine levels in patients with sarcopenia: therefore, future studies using cystatin C are needed to validate our findings.
DOI	10.1016/j.jstrokecerebrovasdis.2020.105491
PMID	33253988