{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:35:14Z","timestamp":1793072114895,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Creatinine\u2010based estimated glomerular filtration rate (eGFRcr) may overestimate kidney function in older adults with reduced muscle mass. Although current guidelines recommend cystatin C when creatinine\u2010based estimates are unreliable, its routine use remains limited. We evaluated whether incorporating simple bedside muscle\u2010related indicators into eGFRcr improves the identification of reduced kidney function defined by cystatin C\u2010based estimated glomerular filtration rate (eGFRcys).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a multicenter cross\u2010sectional study of hospitalized adults aged \u2265\u200960\u2009years at four Japanese community hospitals. Three models were evaluated: eGFRcr only (Basic model), eGFRcr plus calf circumference (Model 1), and eGFRcr plus the finger\u2010ring test (Model 2). The primary outcome was continuous eGFRcys, and eGFRcys &lt;\u200945\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 98 participants (median age 79\u2009years), adding muscle\u2010related indicators modestly improved model performance. Adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      increased from 0.641 (Basic model) to 0.668 (Model 1) and 0.680 (Model 2). The proportion of participants correctly classified with eGFRcys &lt;\u200945\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      increased from 56.1% with the eGFRcr alone to 80.5% with both extended models. Discrimination also improved (area under the curve: 0.882 vs. 0.921 and 0.918, respectively), although the differences were not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incorporating simple bedside muscle\u2010related indicators to creatinine\u2010based assessment improved the identification of reduced kidney function defined by eGFRcys in hospitalized older adults. These measures may complement eGFRcr interpretation when cystatin C measurement is unavailable or delayed. External validation is required before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70851","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:12:35Z","timestamp":1790233955000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Simple Bedside Muscle\u2010Related Indicators Improve the Identification of Reduced Kidney Function in Hospitalized Older Adults: A Multicenter Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5887-4080","authenticated-orcid":false,"given":"Shigemi","family":"Morishita","sequence":"first","affiliation":[{"name":"Department of Surgery Oida Hospital  Sukumo Japan"},{"name":"Department of Clinical Epidemiology Kochi Medical School  Nankoku 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Japan"},{"name":"Department of Internal Medicine Kochi Prefectural Hata\u2010Kenmin Hospital  Sukumo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiichiro","family":"Fujisaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology Iizuka Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-5931","authenticated-orcid":false,"given":"Sho","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Iwase Satellite for Teaching and Research (STAR) Fukushima Medical University  Fukushima Japan"},{"name":"Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE) Fukushima Medical University  Fukushima Japan"},{"name":"Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine Kyoto University  Kyoto 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