scholarly journals Posttransplant muscle mass measured by urinary creatinine excretion rate predicts long-term outcomes after liver transplantation

2018 ◽  
Vol 19 (2) ◽  
pp. 540-550 ◽  
Author(s):  
Suzanne P. Stam ◽  
Maryse C. J. Osté ◽  
Michele F. Eisenga ◽  
Hans Blokzijl ◽  
Aad P. van den Berg ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Muscle Mass ◽  
Excretion Rate ◽  
Long Term Outcomes ◽  
Creatinine Excretion ◽  
Urinary Creatinine ◽  
Urinary Creatinine Excretion ◽  
Creatinine Excretion Rate

scholarly journals Urinary Creatinine Excretion Rate and Mortality in Persons With Coronary Artery Disease

Circulation ◽  
2010 ◽  
Vol 121 (11) ◽  
pp. 1295-1303 ◽  
Author(s):  
Joachim H. Ix ◽  
Ian H. de Boer ◽  
Christina L. Wassel ◽  
Michael H. Criqui ◽  
Michael G. Shlipak ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Excretion Rate ◽  
Creatinine Excretion ◽  
Urinary Creatinine ◽  
Artery Disease ◽  
Urinary Creatinine Excretion ◽  
Creatinine Excretion Rate

Urinary creatinine excretion in the ICU: low excretion does not mean inadequate collection

1993 ◽  
Vol 2 (6) ◽  
pp. 462-466 ◽  
Author(s):  
GR Pesola ◽  
I Akhavan ◽  
GC Carlon
Keyword(s):  
Body Weight ◽  
Actual Body ◽  
Excretion Rate ◽  
Lean Body Weight ◽  
Actual Body Weight ◽  
Creatinine Excretion ◽  
Urinary Creatinine ◽  
Group 2 ◽  
Urinary Creatinine Excretion ◽  
Creatinine Excretion Rate

BACKGROUND: It has been assumed that a urinary creatinine excretion rate of less than 10 mg/kg per day means an inadequately collected urine sample. OBJECTIVE: To determine the frequency of a urinary creatinine excretion rate of less than 10 mg/kg per day in intensive care unit patients with an adequately collected urine sample. METHOD: In a prospective study of creatinine excretion rates, 24-hour urine samples were evaluated for urinary creatinine in 209 critically ill patients with indwelling Foley catheters. Patients from three adult intensive care units in New York City were divided into two groups. Group 1 patients excreted less than 10 mg/kg per day of urinary creatinine, and group 2 patients excreted at least 10 mg/kg per day. Groups 1 and 2 were first evaluated by dividing the creatinine excretion data by actual body weight. Since actual body weight may overestimate body weight in the critically ill patient, data from groups 1 and 2 were also evaluated using lean body weight. RESULTS: Urinary creatinine excretion was less than 10 mg/kg per day in 36.8% of patients using actual body weight and 29.7% of patients adjusted for lean body weight. The average age of patients in group 1 was 74 +/- 17 years for both actual body weight and lean body weight. The average age of group 2 patients was 60 +/- 19 years for actual body weight and 62 +/- 19 years for lean body weight. There was a significant difference in age between group 1 and group 2 patients for both actual body weight and lean body weight. The proportion of female vs male patients with reduced creatinine excretion was significantly greater, whether the actual body weight or lean body weight adjustment was used. CONCLUSIONS: A urinary creatinine excretion rate of less than 10 mg/kg per day occurs in about one third of critically ill patients, who are more likely to be elderly and female.

scholarly journals Variability of Urinary Creatinine in Healthy Individuals

2021 ◽  
Vol 18 (6) ◽  
pp. 3166
Author(s):  
Gerd Sallsten ◽  
Lars Barregard
Keyword(s):  
Flow Rate ◽  
Excretion Rate ◽  
Time Of Day ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Diurnal Variability ◽  
Creatinine Excretion ◽  
Blood Samples ◽  
Urinary Creatinine ◽  
Creatinine Excretion Rate

Many urinary biomarkers are adjusted for dilution using creatinine or specific gravity. The aim was to evaluate the variability of creatinine excretion, in 24 h and spot samples, and to describe an openly available variability biobank. Urine and blood samples were collected from 60 healthy non-smoking adults, 29 men and 31 women. All urine was collected at six time points during two 24 h periods. Blood samples were also collected twice and stored frozen. Analyses of creatinine in urine was performed in fresh urine using an enzymatic method. For creatinine in urine, the intra-class correlation (ICC) was calculated for 24 h urine and spot samples. Diurnal variability was examined, as well as association with urinary flow rate. The creatinine excretion rate was lowest in overnight samples and relatively constant in the other five samples. The creatinine excretion rate in each individual was positively correlated with urinary flow rate. The creatinine concentration was highest in the overnight sample and at 09:30. For 24 h samples the ICC was 0.64, for overnight samples it was 0.5, and for all spot samples, it was much lower. The ICC for urinary creatinine depends on the time of day of sampling. Frozen samples from this variability biobank are open for researchers examining normal variability of their favorite biomarker(s).

Creatinine Excretion

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 140-140
Author(s):  
JAMES L. SUTPHEN
Keyword(s):  
Muscle Mass ◽  
Initial Presentation ◽  
Creatinine Excretion ◽  
Urinary Creatinine ◽  
Weight Measurement ◽  
Body Muscle ◽  
Creatinine Measurement ◽  
Urinary Creatinine Excretion

In Reply.— The questions posed by Harkavy allow me to expand on the initial presentation of the data in my previous report.1 As documented by numerous previous reports, urinary creatinine excretion does, in fact, reflect body muscle mass.2 Furthermore, it has been documented in older infants that creatinine excretion per kilogram increases with the age, weight, and length of the infant.3 The regression data in my report are not expressed in terms of creatinine per kilogram as the dependent variable as this multiplies the error of creatinine measurement by including the error in weight measurement (hydration states etc).

scholarly journals Complementary Biomarker Assessment of Components Absorbed from Diet and Creatinine Excretion Rate Reflecting Muscle Mass in Dialysis Patients

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1827 ◽  
Author(s):  
Adrian Post ◽  
Akin Ozyilmaz ◽  
Ralf Westerhuis ◽  
Karin Ipema ◽  
Stephan Bakker ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Muscle Mass ◽  
Protein Intake ◽  
Excretion Rate ◽  
Protein Energy Malnutrition ◽  
Dialysis Patients ◽  
Sodium Potassium ◽  
Waste Products ◽  
Creatinine Excretion ◽  
Creatinine Excretion Rate

To prevent protein energy malnutrition (PEM) and accumulation of waste products, dialysis patients require diet adjustments. Dietary intake assessed by self-reported intakes often provides biased information and standard 24-h urinary excretion is inapplicable in dialysis patients. We aimed to assess dietary intake via a complementary, less biased biomarker method, and to compare this to dietary diaries. Additionally, we investigated the prospective association of creatinine excretion rate (CER) reflecting muscle mass with mortality. Complete intradialytic dialysate and interdialytic urinary collections were used to calculate 24-h excretion of protein, sodium, potassium, phosphate and creatinine in 42 chronic dialysis patients and compared with protein, sodium, potassium, and phosphate intake assessed by 5-day dietary diaries. Cox regression analyses were employed to investigate associations of CER with mortality. Mean age was 64 ± 13 years and 52% were male. Complementary biomarker assessed (CBA) and dietary assessed (DA) protein intake were significantly correlated (r = 0.610; p < 0.001), but there was a constant bias, as dietary diaries overestimated protein intake in most patients. Correlations were found between CBA and DA sodium intake (r = 0.297; p = 0.056), potassium intake (r = 0.312; p = 0.047) and phosphate uptake/intake (r = 0.409; p = 0.008). However, Bland-Altman analysis showed significant proportional bias. During a median follow-up of 26.6 (25.3–31.5) months, nine dialysis patients (23%) died. CER was independently and inversely associated with survival (HR: 0.59 (0.42–0.84); p = 0.003). Excretion measurements may be a more reliable assessment of dietary intake in dialysis patients, as this method is relatively free from biases known to exist for self-reported intakes. CER seems to be a promising tool for monitoring PEM.

Comparison of techniques to estimate total body skeletal muscle mass in people of different age groups

1999 ◽  
Vol 277 (3) ◽  
pp. E489-E495 ◽  
Author(s):  
D. N. Proctor ◽  
P. C. O’Brien ◽  
E. J. Atkinson ◽  
K. S. Nair
Keyword(s):  
Muscle Mass ◽  
Body Mass ◽  
Total Body Water ◽  
Body Water ◽  
Body Protein ◽  
Creatinine Excretion ◽  
Urinary Creatinine ◽  
Protein Mass ◽  
Total Body ◽  
Urinary Creatinine Excretion

An estimate of total body muscle mass with dual-energy X-ray absorptiometry (DXA; appendicular muscle mass divided by 0.75) was compared with 24-h urinary creatinine excretion in 59 healthy men and women [20–30 yr (younger), 45–59 yr (middle age), and 60–79 yr (older)] who stayed in a clinical research center for 5 days. Total body water (2H2O dilution), fat (underwater weighing), bone mineral (DXA), and total body protein mass (based on a 4-compartment model) were also measured. Muscle mass estimates by DXA and creatinine were highly correlated ( r = 0.80). However, stepwise multiple regression indicated that a significant amount of additional between-subject variability in DXA-based muscle mass estimates could be explained by total body water. Creatinine excretion, knee extensor strength, and total body protein mass all decreased with age, suggesting a decline in muscle cell mass with aging. However, DXA-based muscle mass and measures of nonfat body mass (i.e., lean body mass by2H2O and fat-free body mass by underwater weighing) did not change with age. These results indicate that DXA and urinary creatinine excretion give different results regarding the decline in total body muscle mass with aging. The factor(s) responsible for the apparent underestimate of age-related sarcopenia by DXA remain to be fully defined, but changes in body water may be an important contributor.

scholarly journals Weight Adjusted Urinary Creatinine Excretion Predicts Transplant Outcomes in Adult Patients with Acute Myeloid Leukemia in Complete Remission

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4609-4609
Author(s):  
Akihito Nagata ◽  
Noriko Doki ◽  
Yuki Otsuka ◽  
Ryosuke Konuma ◽  
Hiroto Adachi ◽  
...  
Keyword(s):  
Muscle Mass ◽  
Myeloid Leukemia ◽  
Clinical Impact ◽  
Creatinine Excretion ◽  
Urinary Creatinine ◽  
Transplant Outcomes ◽  
Significant Difference ◽  
Low Bmi ◽  
Urinary Creatinine Excretion ◽  
Group 1

Background: Sarcopenia, the loss of muscle mass, has been recognized as a prognostic factor for cancer patients. For example, low body mass index (BMI) was reported to be a risk of poor overall survival (OS) among allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. However, low BMI was not associated with high non-relapse mortality (NRM) rate, and BMI may not directly reflect the physical condition. (Bone Marrow Transplant. 2014;49:1505-12). To evaluate the clinical impact of the muscle volume on the prognosis of allo-HSCT recipients, other biomarkers that directly reflect muscle mass may be warranted. Urinary creatinine excretion (UCE) has been reported to estimate muscle mass and have prognostic value for kidney transplant patients (Transplantation. 2008;86:391-8.). There is no report to evaluate clinical impact of UCE on the prognosis of allo-HSCT recipients. Therefore, we retrospectively analyzed the association between pre-transplant UCE and the transplant outcomes. Methods: We included 173 adult patients with acute myeloid leukemia (AML) in complete remission (CR) who underwent first allo-HSCT from 2006 to 2017 at our institute and measured UCE before allo-HSCT. Concerned the possibility of urine storage failure, two patients with low total daily urine volume (<0.5L/day) were excluded from this analysis. Therefore, we investigated the remaining 171 patients. In order to correct the physical disparities of individual patients, we evaluated the clinical impact of weight adjusted UCE (WA-UCE) ,i.e UCE / body weight [μmol/kg/day] (Intensive Care Med. 2018;44:1699-708.). We used receiver operating characteristics curve in order to determine the cutoff value of the WA-UCE and classified the patients into the high and low WA-UCE group. We evaluated transplant outcomes such as OS, progression-free survival (PFS), NRM, and cumulative incidence of relapse (CIR) between two groups. Results: The median age at allo-HSCT was 52 (range, 18-73) and there were more male patients (n=111) than female patients (n=60). Regarding cytogenetic risk, 15 (9.1%), 112 (65.8%), and 38 (23.0%) were categorized as favorable, intermediate, and poor risk, respectively (There were five patients without cytogenetic data). The median follow-up period of survivors was 704 (range, 9 to 3,857) days. We defined the cutoff value of the weight adjusted UCE as 148 μmol/kg/day in male and 128 μmol/kg/day in female. Among 171 patients, 90 patients (male = 59, female = 31) were in the high WA-UCE group and 81 patients (male = 52, female = 29) were in the low WA-UCE group. We found no significant differences between two groups in terms of the number of relapse before allo-HSCT, cytogenetic risks, conditioning regimens, hematopoietic cell transplantation comorbidity index, donor-recipient HLA matching, donor source, or estimated glomerular filtration rate. On the other hand, patient's age at allo-HSCT was significantly younger (low vs. high WA-UCE group: median, 53 [range, 18 - 73] vs. 48 [range, 19 - 68] years, P = 0.02) and BMI was lower (low vs. high WA-UCE group: median, 22.3 [range, 15.4 - 38.8] vs. 21.9 [range, 15.4 - 29.3] kg/m2, P = 0.003) in high WA-UCE group. In univariate analysis, we observed a significant difference in OS, PFS, and NRM between two groups (low vs. high WA-UCE group: 1-year OS, 60.1% vs. 80.9%, P < 0.01; 1-year PFS, 54.1% vs. 70.9%, P = 0.02; 1-year NRM, 24.8% vs. 12.3%, P = 0.02) (Figure1). On the other hand, there was no significant difference in 1-year CIR between two groups (low vs. high WA-UCE group: 21.1% vs. 16.8%, P = 0.63). In our cohort, the low BMI (< 18.5 kg/m2) was not significantly associated with OS, PFS, CIR, and NRM (low vs. high BMI group: 1-year OS, 77.6% vs. 69.9%, P = 0.51; 1-year PFS, 74.1% vs. 60.9%, P = 0.45; 1-year CIR, 14.8% vs. 19.5%, P = 0.02, 1-year NRM, 11.1% vs. 19.5%, P = 0.70) In multivariate analysis, the low WA-UCE was an independent risk factor for OS (Hazard ratio (HR) [95% confidence interval (CI)]; 2.29 [1.38 - 3.80], P < 0.01), PFS (HR [95% CI]; 1.76 [1.11 - 2.79], P = 0.02), and NRM (HR [95% CI]; 2.22 [1.13 - 4.36], P = 0.02) (table1). Conclusion: In allo-HSCT adult recipients with AML in CR, low WA-UCE before transplantation was associated with poor prognosis, which related to high NRM within 1 year. WA-UCE can be an independent, objective, simple, and reliable biomarker for evaluating muscle mass and predicting transplant outcome. Disclosures No relevant conflicts of interest to declare.

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