Creatinine excretion in dialysis patients : A measure of muscle mass and muscle function

Poppe, E. (Enya) (2016) Creatinine excretion in dialysis patients : A measure of muscle mass and muscle function. thesis, Medicine.

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Abstract

Background: Chronic kidney disease (CKD) can be considered as a state of accelerated ageing, and is accompanied by a gradual decline in muscle quantity and muscle quality, called sarcopenia. The loss of muscle quantity and quality is associated with unfavorable outcomes in the CKD population, including worse quality of life, malnutrition, higher risk of hospitalizations, and death. Creatinine excretion is an established measure of muscle mass. At present it is unknown whether creatinine excretion in the CKD population might also capture information about muscle function, as the relation between creatinine excretion and muscle function has not been studied yet. Furthermore, dietary protein intake may influence muscle mass and muscle function. The aim of this study was to investigate the association of creatinine excretion, as a marker of muscle mass, with muscle strength and gait speed. Methods: In 40 hemodialysis (HD) and 10 peritoneal dialysis (PD) patients creatinine excretion (CrE) was measured as the sum of CrE by dialytic removal and urinary excretion in case of residual kidney function. Muscle function was assessed by handgrip strength (HGS) and by gait speed as a general measure of functioning. A 5-day food diary evaluated dietary protein intake. Results: A significant positive correlation was found between CrE and HGS. Gait speed was not significantly correlated with CrE, except in subanalyses of male and HD patients. Protein intake adjusted for weight did not associate with either CrE, HGS or gait speed. Conclusion: CrE is not only a measure for muscle mass, but also for muscle strength. A higher protein intake does not result in a higher muscle mass or better muscle function, since there was no significant correlation between CrE and protein intake per kg body weight. Protein intake seems to be no solution to prevent the loss of muscle mass and muscle function in dialysis patients. Future studies should explore whether physical activity in combination with higher protein intake results in preservation of muscle mass and muscle function.

Item Type:	Thesis (Thesis)
Supervisor name:	Onder begeleiding van: and Franssen, Dr. C.F.M. and Polinder-Bos, Dr. H.A. and Bakker, Prof. dr. S.J.L. and Interne geneeskunde and Nefrologie UMCG en DCG
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:39
Last Modified:	25 Jun 2020 10:39
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/88

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