Muscle Mass Significantly Impacts Kidney Transplant Function Estimates

Strategic Insights -

A new study has shed light on the crucial impact of muscle mass on estimating glomerular filtration rate (eGFR) in kidney transplant recipients (KTR). Researchers at Necker Hospital for Sick Children (INEM) in Paris, France, investigated the relationship between muscle mass and eGFR accuracy in a cohort of 1829 KTR. The study found that muscle mass significantly affects the performance of five widely used eGFR equations, with the EKFC equation being the least sensitive to muscle mass. Moreover, incorporating muscle mass into KTR's evaluations may improve kidney function assessments and mortality risk assessment.

Key Takeaways:

  • Muscle mass plays a significant role in estimating glomerular filtration rate (eGFR) in kidney transplant recipients (KTR).
  • The study evaluated the impact of muscle mass on the performance of five eGFR equations (MDRD, CKDEPI, CKDEPI, EKFC, and RFKTS) using multiple regression and subgroup analysis.
  • The EKFC equation was found to be the least sensitive to muscle mass (b coefficient 95% CI: -0.17 to -0.12).
  • All eGFR equations demonstrated reduced accuracy in the lowest muscle mass tertile.
  • Including muscle mass 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: 0.99-1; EKFC: 0.98-1; RFKS: 0.98-0.999).
  • The study concluded that incorporating muscle mass into KTR's evaluations may improve kidney function assessments and mortality risk assessment.

Statistics:

  • 1829 KTR were included in the study.
  • The mean age of the participants was 52 ± 14 years.
  • 38.9% of the participants were female.
  • The study found a significant negative correlation between muscle mass and eGFR in all equations (MDRD, CKDEPI, CKDEPI, EKFC, and RFKTS).
  • The EKFC equation was the least sensitive to muscle mass (b coefficient 95% CI: -0.17 to -0.12).
  • ioGFR was significantly associated with mortality (hazard ratio 95% CI: 0.972-0.995), but eGFRs were not.

Sources:

  • "Impact of Muscle Mass on the Performance of Creatinine-Based eGFR Equations and Mortality Risk Assessment After Kidney Transplantation" (Journal of Cachexia, Sarcopenia and Muscle, 2025;16(5)).
  • Journal of Cachexia, Sarcopenia and Muscle (www.springerlink.com/content/2190-5991/).
  • Wiley (111 River St, Hoboken 07030-5774, NJ, USA).
  • Melissa Ould Rabah, Service de Physiologie, Necker Hospital for Sick Children (INEM), Assistance-Publique-Hopitaux de Paris, Paris, France.
  • Additional authors: Francois Gaillard, Olivier Aubert, Nicolas Garcelon, Antoine Neuraz, Christophe Legendre, Dany Anglicheau, Dominique Prie, and Frank Bienaime.
  • NewsRx. Studies from Necker Hospital for Sick Children (INEM) Provide New Data on Kidney Transplants (Health & Medicine Week, October 17, 2025; p 7341).