E-ISSN: 2667-6370
Creatinine Excretion as a Determinant of Accelerated Skeletal Muscle Loss with Critical Illness
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Original Article
VOLUME: 46 ISSUE: 4
P: 311-315
August 2018

Creatinine Excretion as a Determinant of Accelerated Skeletal Muscle Loss with Critical Illness

Turk J Anaesthesiol Reanim 2018;46(4):311-315
DOI: 10.5152/TJAR.2018.60437
Jehanzeb Khan 1
Khushbir Bath 1
Fareeha Hafeez 1
Gayoung Kim 2
Gene R. Pesola 1
1. Department of Medicine, Section of Critical Care/Pulmonary Medicine, Harlem Hospital/Columbia University, New York, USA
2. Department of Nursing, Harlem Hospital/Columbia University, New York, USA
No information available.
No information available
Received Date: 13.01.2017
Accepted Date: 09.02.2018
Publish Date: 25.06.2018
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ABSTRACT

Objective:

The 24-h urinary creatinine excretion rate has been used as an approximation of the skeletal muscle (SM) mass in non-intensive care unit (ICU) settings. The study goal or aim was to determine reductions in SM mass in patients with recurrent critical illness who are admitted to a medical ICU.

Methods:

Retrospective ICU patient records between 2013 and 2015 were reviewed. Inclusion of ICU patients with repeat 24-h urinary creatinine excretion levels at two different ICU admissions done routinely as part of care. The study design is a case series with patients as their own control.

Results:

Three patients were found to have data on two separate ICU admissions. The reduction in creatinine excretion among ICU patients was correlated with estimated SM mass. All patients had >50% reduction in creatinine excretion and ≥47% reduction in estimated SM mass over 4 months. All patients were bed-bound after the first ICU admission and met the definition of sarcopenia by the second ICU admission; all patients died during the second ICU admission. The final SM mass in all patients was <4 kg m-2.

Conclusion:

Patients with chronic critical illness admitted to the medical ICU, who become bed bound, can experience up to 50% reduction in SM mass as gleaned from creatinine excretion within 4 months. Low SM mass may predispose patients to increased mortality. Measurement of 24-h urinary creatinine excretion may be a useful ICU biomarker to determine SM mass for diagnostic and prognostic purposes.