{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:28:48Z","timestamp":1764048528702,"version":"3.45.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T00:00:00Z","timestamp":1616198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["FP7\u2010242209\u2010BIOSTAT\u2010CHF"],"award-info":[{"award-number":["FP7\u2010242209\u2010BIOSTAT\u2010CHF"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Muscle wasting and unintentional weight loss (cachexia) have been associated with worse outcomes in heart failure (HF), but timely identification of these adverse phenomena is difficult. Spot urinary creatinine may be an easily accessible marker to assess muscle loss and cachexia. This study investigated the association of urinary creatinine with body composition changes and outcomes in patients with new\u2010onset or worsening HF (WHF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In BIOSTAT\u2010CHF, baseline spot urinary creatinine measurements were available in 2315 patients with new\u2010onset or WHF in an international cohort (index cohort) and a validation cohort of 1431 similar patients from Scotland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median spot urinary creatinine concentrations were 5.2 [2.7\u20139.6] mmol\/L in the index cohort. Median age was 69\u00a0\u00b1\u00a012\u00a0years and 73% were men. Lower spot urinary creatinine was associated with older age, lower height and weight, worse renal function, more severe HF, and a higher risk of &gt;5% weight loss from baseline to 9\u00a0months (odds ratio\u00a0=\u00a01.23, 95% CI\u00a0=\u00a01.09\u20131.39 per log decrease;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001). Spot urinary creatinine was associated with Evans criteria of cachexia (OR\u00a0=\u00a01.26 per log decrease, 95% CI\u00a0=\u00a01.04\u20131.49;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.016) and clustered with markers of heart failure severity in hierarchical cluster analyses. Lower urinary creatinine was associated with poorer exercise capacity and quality of life (both\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and predicted a higher rate for all\u2010cause mortality [hazard ratio (HR)\u00a0=\u00a01.27, 95% CI\u00a0=\u00a01.17\u20131.38 per log decrease;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001] and the combined endpoints HF hospitalization or all\u2010cause mortality (HR\u00a0=\u00a01.23, 95% CI\u00a0=\u00a01.15\u20131.31 per log decrease;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Significance was lost after addition of the BIOSTAT risk model. Analyses of the validation cohort yielded similar findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lower spot urinary creatinine is associated with smaller body dimensions, renal dysfunction, and more severe HF in patients with new\u2010onset\/WHF. Additionally, lower spot urinary creatinine is associated with an increased risk of weight loss and a poorer exercise capacity\/quality of life. Urinary creatinine could therefore be a novel, easily obtainable marker to assess (risk of) muscle wasting in HF patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.12690","type":"journal-article","created":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T04:40:03Z","timestamp":1616215203000},"page":"555-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["The value of spot urinary creatinine as a marker of muscle wasting in patients with new\u2010onset or worsening heart failure"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2031-2314","authenticated-orcid":false,"given":"Paloma","family":"Pandhi","sequence":"first","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koen W.","family":"Streng","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0805-8683","authenticated-orcid":false,"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK) partner site Berlin Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1471-7016","authenticated-orcid":false,"given":"John G.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics &amp; Clinical Trials Unit, University of Glasgow and Clinical Cardiology, National Heart &amp; Lung Institute Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0190-2228","authenticated-orcid":false,"given":"Kevin","family":"Damman","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Dickstein","sequence":"additional","affiliation":[{"name":"University of Bergen, Stavanger University Hospital  Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7175-0464","authenticated-orcid":false,"given":"Pierpaolo","family":"Pellicori","sequence":"additional","affiliation":[{"name":"Robertson Institute of Biostatistics and Clinical Trials Unit University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4530-3078","authenticated-orcid":false,"given":"Chim C.","family":"Lang","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School University of Dundee  Dundee UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6553-5749","authenticated-orcid":false,"given":"Leong","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester, Glenfield Hospital, and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilesh J.","family":"Samani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester, Glenfield Hospital, and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-1570","authenticated-orcid":false,"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"CHU de Nancy, Inserm CIC 1433 Universit\u00e9 de Lorrain, CHRU de Nancy, F\u2010CRIN INI\u2010CRCT  Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-8568","authenticated-orcid":false,"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia  Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-3873","authenticated-orcid":false,"given":"Patrick","family":"Rossignol","sequence":"additional","affiliation":[{"name":"Inserm, Centre d'Investigations Cliniques\u2010Plurith\u00e9matique 1433, Inserm U1116; CHRU Nancy; F\u2010CRIN INI\u2010CRCT Network Universit\u00e9 de Lorraine  Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Department of Cardiology, School of Medicine Athens University Hospital Attikon, National and Kapodistrian University of Athens  Athens Greece"},{"name":"School of Medicine University of Cyprus  Nicosia Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk J.","family":"van Veldhuisen","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5417-4415","authenticated-orcid":false,"given":"Adriaan A.","family":"Voors","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozine M.","family":"ter Maaten","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.240"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07015-8"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn420"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs381"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.09.079"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2017.51"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.11.043"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/37.3.478"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.05.010"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-014-0738-7"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.924266"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1545"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03790414"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0111949"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.01.017"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0137460"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.531"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1323"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1437"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10701016"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.10.010"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70218-7"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2008.06.013"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.785"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02870707"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/63.6.863"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09300911"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.09.007"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.09.072"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.17-057"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000496460"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2017.11.016"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.12.019"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12237"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12501"}],"container-title":["Journal 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