The following is the summary of “Association of the modified creatinine index with muscle strength and mortality in patients undergoing hemodialysis” published in the October 2022 issue of Renal failure by Tian, et al.

According to the revised agreement, a diagnosis of likely sarcopenia is made when weak muscles are present rather than when a low total body mass is found. It is unclear if people with likely sarcopenia might be identified as at risk of unfavorable outcomes using the modified creatinine index (mCI). Researchers intended to determine if hemodialysis patients with high mCI scores were more likely to develop sarcopenia and die from their condition. The correlation between mCI and sarcopenia was examined by univariate and multivariate logistic regression analysis in the cross-sectional study (n=346). The nutritional status was assessed using the Modified Quantitative Subjective Global Assessment (MQSGA) assessed the nutritional status. 

This study used receiver operating characteristic (ROC) curve analysis to evaluate the mCI value’s ability to detect likely sarcopenia. Youden’s approach was used to find the correct thresholds. Crude and adjusted hazard ratios and 95% confidence intervals (CIs) of death by mCI and MQSGA were evaluated using cox proportional regression models in a longitudinal cohort analysis of an independent hemodialysis cohort (n=218). After controlling for potential confounding factors, the correlation between mCI and weak muscles remained significant in the cross-sectional analysis. Among men, the mCI had an area under the curve (AUC) of 0.804 (95% CI, 0.744-0.863; P<0.001) for predicting probable sarcopenia, while among women, it had an AUC of 0.787 (95% CI, 0.711-0.864; P<0.001). The best mCI cutoff value for men was 21.07 mg/kg/d, whereas, for women, it was 19.57 mg/kg/d. According to the follow-up data, people with low mCI had a greater chance of dying from any cause than those with high mCI did (adjusted HR, 2.51; 95% CI, 1.16-5.41; P=0.019). 

The C-index for death prediction increased from 0.785 to 0.805 (P=0.026), and the net reclassification index increased by 38.6% (P=0.021) when the mCI was included, while the addition of MQSGA had no effect. The mCI is more accurate than the MQSGA at predicting mortality in hemodialysis patients since it measures muscular strength and survival. The evaluation of mCI may supplement sarcopenia’s predictive and prognostic value.