293: Association of Pre-Transplant Serum Creatinine as a Potential Muscle Mass Surrogate and 5-Year Patient and Graft Survival in 10,090 Hemodialysis Patients

Abstract

Background: Larger lean body & muscle mass may be associated with greater survival in hemodialysis (HD) patients (pts) but its association with post-transplant outcomes is not known. We hypothesized that a higher pre-dialysis serum creatinine, a surrogate of muscle mass, in the months prior to transplant is associated with better post-transplant outcomes. Methods: After merging the “Scientific Registry of Transplant Recipients” database with DaVita national database of HD pts over 5 yrs (7/01-6/06), we identified 10,090 renal transplant recipients (RTR), in whom time to death or graft failure was calculated. Results: Pts were 49±13 yrs old and included 49% women, 45% diabetics & 27% Blacks. The 3-mo averaged creatinine prior to transplant was 10.6±3/2 mg/dL. Cox models adjusted for case-mix & “malnutritioninflammationcachexia syndrome” (MICS) showed a linear and incremental association with the composite pt & graft survival (see Figure). (Graph Presented) Conclusions: If average predialysis serum creatinine is a surrogate of muscle mass in HD pts, larger muscle mass appears associated with better post-transplant outcomes. Trials to examine intervention to improve sarcopenia are indicated in transplant wait-listed pts.