{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:18:08Z","timestamp":1790813888554,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Estimating glomerular filtration rate (eGFR) in kidney transplant recipients (KTR) typically relies on plasma creatinine, which is influenced by muscle mass. Reduced muscle mass is suspected to reduce eGFR performance in this population but this effect has not been rigorously evaluated. This study quantified the impact of muscle mass on eGFR accuracy and its confounding effect on the association between kidney function and mortality in KTR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We studied a prospective and consecutive cohort of 1829 KTR (mean age 52\u2009\u00b1\u200914\u2009years; 38.9% female) who underwent GFR measurement using iohexol clearance (ioGFR). Muscle mass was assessed by creatinine excretion rate (CER) from timed urine collections. We evaluated the impact of muscle mass on the performance of five eGFR equations (MDRD, CKDEPI\n                      <jats:sub>2009<\/jats:sub>\n                      , CKDEPI\n                      <jats:sub>2021<\/jats:sub>\n                      , EKFC and RFKTS) using multiple regression and subgroup analysis. The association between eGFRs, ioGFR and mortality was examined using Cox proportional hazards models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All eGFR equations showed a significant negative correlation with CER. EKFC was the least sensitive to CER (\n                      <jats:bold>\n                        <jats:italic>\u03b2<\/jats:italic>\n                      <\/jats:bold>\n                      coefficient 95% confidence interval [CI]: \u22120.17 to \u22120.12). All eGFR equations demonstrated reduced accuracy in the lowest muscle mass tertile. In multivariable analyses, ioGFR was significantly associated with mortality (hazard ratio 95% CI: 0.972\u20130.995) but eGFRs were not. Including CER in the Cox models resulted in convergence of the mortality hazard ratios for ioGFR and eGFRs (hazard ratio 95% CI: ioGFR: 0.98\u20130.999; MDRD: 0.98\u20130.999; CKDEPI\n                      <jats:sub>2021<\/jats:sub>\n                      : 0.99\u20131; EKFC (0.98\u20131) RFKS: 0.98\u20130999).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The performance of all tested creatinine\u2010based eGFR equations is strongly impacted by muscle mass. Muscle mass is also a key confounder in the mortality risk assessment using eGFR. Incorporating muscle mass into KTR's evaluations may improve kidney function assessments in KTR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70032","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T16:41:01Z","timestamp":1759164061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of Muscle Mass on the Performance of Creatinine\u2010Based eGFR Equations and Mortality Risk Assessment After Kidney Transplantation"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7248-8418","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Gaillard","sequence":"first","affiliation":[{"name":"Service de Transplantation, N\u00e9phrologie et Immunologie Clinique H\u00f4pital Edouard Herriot et Facult\u00e9 de M\u00e9decine, Universit\u00e9 Lyon 1  Lyon France"},{"name":"Research on Healthcare Performance RESHAPE INSERM U1290, Universit\u00e9 Claude Bernard Lyon 1  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2315-9738","authenticated-orcid":false,"given":"Melissa\u00a0Ould","family":"Rabah","sequence":"additional","affiliation":[{"name":"Service de Physiologie H\u00f4pital Necker\u2010Enfants Malades, Assistance\u2010Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"Facult\u00e9 de m\u00e9decine Universit\u00e9 de Paris\u2010Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Aubert","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine Universit\u00e9 de Paris\u2010Cit\u00e9  Paris France"},{"name":"Service de N\u00e9phrologie et Transplantation H\u00f4pital Necker\u2010Enfants Malades, Assistance\u2010Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"Institut Necker\u2010Enfants Malades, INSERMU1151 Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Garcelon","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Imagine Institute, Data Science Platform, INSERM UMR 1163  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Neuraz","sequence":"additional","affiliation":[{"name":"Service d'Informatique M\u00e9dical H\u00f4pital Necker\u2010Enfants Malades, Assistance\u2010Publique\u2010H\u00f4pitaux de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Legendre","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine Universit\u00e9 de Paris\u2010Cit\u00e9  Paris France"},{"name":"Service de N\u00e9phrologie et Transplantation H\u00f4pital Necker\u2010Enfants Malades, Assistance\u2010Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"Institut Necker\u2010Enfants Malades, INSERMU1151 Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dany","family":"Anglicheau","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine Universit\u00e9 de Paris\u2010Cit\u00e9  Paris France"},{"name":"Service de N\u00e9phrologie et Transplantation H\u00f4pital Necker\u2010Enfants Malades, Assistance\u2010Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"Institut Necker\u2010Enfants Malades, INSERMU1151 Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Pri\u00e9","sequence":"additional","affiliation":[{"name":"Service de Physiologie H\u00f4pital Necker\u2010Enfants Malades, Assistance\u2010Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"Facult\u00e9 de m\u00e9decine Universit\u00e9 de Paris\u2010Cit\u00e9  Paris France"},{"name":"Institut Necker\u2010Enfants Malades, INSERMU1151 Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8666-2042","authenticated-orcid":false,"given":"Frank","family":"Bienaim\u00e9","sequence":"additional","affiliation":[{"name":"Service de Physiologie H\u00f4pital Necker\u2010Enfants Malades, Assistance\u2010Publique\u2010H\u00f4pitaux de Paris  Paris France"},{"name":"Facult\u00e9 de m\u00e9decine Universit\u00e9 de Paris\u2010Cit\u00e9  Paris France"},{"name":"Institut Necker\u2010Enfants Malades, INSERMU1151 Paris  Paris 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n\u00b0 2018\u2013155 du 3 Mai 2018 Portant Homologation de la M\u00e9thodologie de R\u00e9f\u00e9rence Relative aux Traitements de Donn\u00e9es \u00e0 Caract\u00e8re Personnel mis en \u0152uvre Dans le Cadre des Recherches N'impliquant pas la Personne Humaine des \u00c9tudes et \u00c9valuations \u201dhttps:\/\/www.legifrance.gouv.fr\/affichTexte.do?cidTexte=JORFTEXT000037187498&categorieLien=id."},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012060614"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ\u20102022\u2010073654"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/AJT.14258"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2022.03.014"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12399"}],"container-title":["Journal of Cachexia, Sarcopenia and 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