Table 4.
Associations of predialysis plasma concentrations of arginine, guanidinoacetate, creatine and creatinine with characteristics of the protein energy wasting phenotype
| Sex-adjusted analyses | Multivariable analyses | |||
|---|---|---|---|---|
| OR (95% CI) | P value | OR (95% CI) | P value | |
| Plasma arginine (per 1-SD decrease) | ||||
| Low muscle mass | 1.65 [0.84–3.89] | 0.2 | 1.60 [0.74–4.27] | 0.3 |
| Low protein intake | 1.94 [1.08–3.94] | 0.04 | 1.91 [1.01–4.16] | 0.07 |
| Hypoalbuminemia | 2.50 [1.35–5.33] | 0.007 | 2.87 [1.39–7.06] | 0.009 |
| Low BMI | 1.06 [0.59–1.86] | 0.8 | 0.91 [0.32–2.89] | 0.9 |
| Severe fatigue | 1.14 [0.63–2.08] | 0.7 | 1.04 [0.50–2.15] | 0.9 |
| Plasma guanidinoacetate (per 1-SD decrease) | ||||
| Low muscle mass | 1.08 [0.59–2.19] | 0.8 | 0.94 [0.48–2.08] | 0.9 |
| Low protein intake | 1.55 [0.89–2.94] | 0.2 | 1.11 [0.60–2.24] | 0.7 |
| Hypoalbuminemia | 1.45 [0.82–2.65] | 0.2 | 1.35 [0.71–2.67] | 0.3 |
| Low BMI | 1.17 [0.66–2.08] | 0.6 | 1.61 [0.70–3.77] | 0.2 |
| Severe fatigue | 1.20 [0.69–2.15] | 0.5 | 0.96 [0.49–1.84] | 0.9 |
| Plasma creatine (per halving) | ||||
| Low muscle mass | 2.00 [1.05–4.14] | 0.04 | 2.32 [1.10–5.69] | 0.04 |
| Low protein intake | 2.13 [1.17–4.27] | 0.02 | 2.37 [1.20–5.41] | 0.02 |
| Hypoalbuminemia | 3.13 [1.46–8.02] | 0.008 | 6.20 [2.16–24.8] | 0.003 |
| Low BMI | 0.74 [0.40–1.35] | 0.3 | 0.51 [0.18–1.28] | 0.2 |
| Severe fatigue | 3.20 [1.52–8.05] | 0.006 | 3.74 [1.55–11.8] | 0.009 |
| Plasma creatinine (per 1-SD decrease) | ||||
| Low muscle mass | 6.66 [2.14–28.6] | 0.003 | 5.67 [1.59–37.3] | 0.03 |
| Low protein intake | 1.35 [0.80–2.43] | 0.3 | 3.15 [0.82–3.29] | 0.2 |
| Hypoalbuminemia | 2.51 [1.35–5.41] | 0.006 | 2.50 [1.25–5.72] | 0.02 |
| Low BMI | 1.80 [1.02–3.45] | 0.05 | 2.58 [0.94–9.66] | 0.10 |
| Severe fatigue | 1.09 [0.62–1.90] | 0.76 | 1.65 [0.80–3.51] | 0.18 |
Plasma refers to plasma values predialysis. Analyses of plasma arginine, guanidinoacetate and creatinine are performed on scaled data, with the odds ratio presented per standard deviation decrease of the biomarker. Analyses of plasma creatine are performed on log2 transformed data, with the odds ratio presented per halving of the biomarker
Low muscle mass is defined as a muscle mass < 10.76 kg/m2 in males < 6.76 kg/m2 in females. Low protein intake is defined as a protein intake < 0.8 g/kg/24-h. Low BMI is defined as a BMI < 23 kg/m2. Hypoalbuminemia is defined as a serum albumin < 38 g/L. Severe fatigue is defined as a subjective fatigue score ≥ 35. Multivariable analyses are adjusted for sex, age, body surface area, dialysis vintage and hs-CRP