LAUSR

INTRODUCTION Maintenance haemodialysis is a catabolic state associated with significant decrease in lean body mass (LBM) and protein energy wasting. LBM can be derived or estimated from creatinine kinetic modelling, specifically the creatinine index (CI). This has been demonstrated in cohort studies predict mortality. METHODS 179 patients undergoing haemodialysis in 2015 were included in this cohort. They were followed for five years with pertinent clinical data collected to calculate the CI as of December 2015. For the purposes of analysis, patients were split into a high and low CI group based upon the median (18.32 mg/kg/day). The primary outcome of interest was all-cause mortality and secondary outcomes included myocardial infarction, stroke and transplantation. RESULTS During follow up, 69 (76.7%) patients in the low CI group and 28 (31.5%) patients in the high CI group died (p < 0.001). The relative risk (RR) of mortality within the low compared to high CI group was 2.43 (95% CI 1.75-3.38). Fully adjusted cox proportional hazards modelling demonstrated a HR = 0.498 (95% CI 0.292-0.848) for survival in the high CI group. Lower CI was associated with increased risk of stroke (RR 5.43; 95% CI 1.24-23.84) while transplant was more likely in the high CI group (RR 6.4; 95% CI 1.96-20.88). CONCLUSION In a single centre Australian haemodialysis cohort, the CI was strongly associated with mortality and stroke risk. The CI is an accurate and simple method to identify patients with low lean body mass, at risk of significant morbidity and mortality. This article is protected by copyright. All rights reserved.