{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:45:17Z","timestamp":1791812717267,"version":"4.3.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["21H03201"],"award-info":[{"award-number":["21H03201"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia is associated with adverse outcomes in CKD, but direct assessment of skeletal muscle mass is not always available. We examined whether serum creatinine- and cystatin C-derived estimated skeletal muscle index (SMI), combined with handgrip strength, identifies a sarcopenia-related high-risk phenotype in non\u2013dialysis-dependent CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We derived a new equation for appendicular skeletal muscle mass using bioelectrical impedance analysis as the reference in 100 patients with non\u2013dialysis-dependent CKD. In an independent multicenter cohort of 1403 patients, SMI was estimated using this equation and a published creatinine-cystatin C-based formula. The sarcopenia-related high-risk phenotype was defined as low handgrip strength plus low estimated SMI using sex-specific cutoffs. Outcomes were all-cause, cardiovascular, and noncardiovascular mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 5 years, 173 patients died, including 43 from cardiovascular causes. Low estimated SMI was identified in 218 patients (15.5%) with the published formula and 312 (22.2%) with the new equation; the corresponding phenotype prevalences were 11.9% and 11.7%. The phenotype was independently associated with all-cause mortality using either formula: adjusted hazard ratios were 1.54 [95% confidence interval (CI), 1.07\u20132.21] for the published formula and 2.14 (95% CI, 1.52\u20133.00) for the new equation. Four-category and sensitivity analyses yielded consistent findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combining handgrip strength with creatinine- and cystatin C-derived estimated SMI identifies a sarcopenia-related high-risk phenotype and stratifies mortality risk in non\u2013dialysis-dependent CKD. This approach may support screening when direct muscle mass assessment is unavailable but requires further validation before use as a diagnostic substitute.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag336","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:13:13Z","timestamp":1790334793000},"source":"Crossref","is-referenced-by-count":0,"title":["A blood test-derived skeletal muscle index combined with handgrip strength identifies a sarcopenia-related high-risk phenotype in non\u2013dialysis-dependent chronic kidney disease"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5511-7511","authenticated-orcid":false,"given":"Shunsuke","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University , Fukuoka ,","place":["Japan"]},{"name":"Division of Kidney Care Unit, Kyushu University Hospital , 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