Serum creatinine as a marker of muscle mass in chronic kidney disease: Results of a cross-sectional study and review of literature

Sapna S. Patel, Miklos Z. Molnar, John A. Tayek, Joachim H. Ix, Nazanin Noori, Deborah Benner, Steven Heymsfield, Joel D. Kopple, Csaba Kovesdy, Kamyar Kalantar-Zadeh

Research output: Contribution to journalReview article

104 Citations (Scopus)

Abstract

Background: Higher muscle mass is associated with better outcomes and longevity in patients with chronic disease states. Imaging studies such as dual-energy X-ray absorptiometry (DEXA) are among the gold standard methods for assessing body fat and lean body mass (LBM), approximately half of which is comprised of skeletal muscle mass. Elaborate imaging devices, however, are not commonly available in routine clinical practice and therefore easily accessible and cost-effective, but reliable muscle mass biomarkers are needed. One such marker is serum creatinine, derived from muscle-based creatine, which is inexpensive and ubiquitously available, and it can serve as a biomarker of skeletal muscle mass in human subjects. Methods and results: In 118 hemodialysis patients, we found that the 3-month averaged serum creatinine concentration correlated well with DEXA-measured LBM. The recent literature regarding serum creatinine as a surrogate of muscle mass is summarized, as is the literature concerning the use of other measures of muscle mass, such as plasma gelsolin and actin, and urinary creatinine excretion. We have also reviewed the role of dietary meat intake in serum creatinine variability along with several biomarkers of dietary meat intake (creatine, carnitine, carnosine, ophidine, anserine, 3-methyl-l-histidine and 1-methylhistidine). Conclusion: In summary, none of these biomarkers was studied in CKD patients. We advance the hypothesis that in both health and disease, under steady state, serum creatinine can serve as a reliable muscle mass biomarker if appropriate adjustment for full or residual kidney function and dietary meat intake is undertaken.

Original languageEnglish (US)
Pages (from-to)19-29
Number of pages11
JournalJournal of Cachexia, Sarcopenia and Muscle
Volume4
Issue number1
DOIs
StatePublished - Jan 1 2013

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Chronic Renal Insufficiency
Creatinine
Cross-Sectional Studies
Biomarkers
Muscles
Anserine
Serum
Meat
Creatine
Photon Absorptiometry
Skeletal Muscle
Gelsolin
Carnosine
Carnitine
Histidine
Renal Dialysis
Adipose Tissue
Actins
Chronic Disease
Kidney

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Physiology (medical)

Cite this

Serum creatinine as a marker of muscle mass in chronic kidney disease : Results of a cross-sectional study and review of literature. / Patel, Sapna S.; Molnar, Miklos Z.; Tayek, John A.; Ix, Joachim H.; Noori, Nazanin; Benner, Deborah; Heymsfield, Steven; Kopple, Joel D.; Kovesdy, Csaba; Kalantar-Zadeh, Kamyar.

In: Journal of Cachexia, Sarcopenia and Muscle, Vol. 4, No. 1, 01.01.2013, p. 19-29.

Research output: Contribution to journalReview article

Patel, Sapna S. ; Molnar, Miklos Z. ; Tayek, John A. ; Ix, Joachim H. ; Noori, Nazanin ; Benner, Deborah ; Heymsfield, Steven ; Kopple, Joel D. ; Kovesdy, Csaba ; Kalantar-Zadeh, Kamyar. / Serum creatinine as a marker of muscle mass in chronic kidney disease : Results of a cross-sectional study and review of literature. In: Journal of Cachexia, Sarcopenia and Muscle. 2013 ; Vol. 4, No. 1. pp. 19-29.
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AU - Patel, Sapna S.

AU - Molnar, Miklos Z.

AU - Tayek, John A.

AU - Ix, Joachim H.

AU - Noori, Nazanin

AU - Benner, Deborah

AU - Heymsfield, Steven

AU - Kopple, Joel D.

AU - Kovesdy, Csaba

AU - Kalantar-Zadeh, Kamyar

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N2 - Background: Higher muscle mass is associated with better outcomes and longevity in patients with chronic disease states. Imaging studies such as dual-energy X-ray absorptiometry (DEXA) are among the gold standard methods for assessing body fat and lean body mass (LBM), approximately half of which is comprised of skeletal muscle mass. Elaborate imaging devices, however, are not commonly available in routine clinical practice and therefore easily accessible and cost-effective, but reliable muscle mass biomarkers are needed. One such marker is serum creatinine, derived from muscle-based creatine, which is inexpensive and ubiquitously available, and it can serve as a biomarker of skeletal muscle mass in human subjects. Methods and results: In 118 hemodialysis patients, we found that the 3-month averaged serum creatinine concentration correlated well with DEXA-measured LBM. The recent literature regarding serum creatinine as a surrogate of muscle mass is summarized, as is the literature concerning the use of other measures of muscle mass, such as plasma gelsolin and actin, and urinary creatinine excretion. We have also reviewed the role of dietary meat intake in serum creatinine variability along with several biomarkers of dietary meat intake (creatine, carnitine, carnosine, ophidine, anserine, 3-methyl-l-histidine and 1-methylhistidine). Conclusion: In summary, none of these biomarkers was studied in CKD patients. We advance the hypothesis that in both health and disease, under steady state, serum creatinine can serve as a reliable muscle mass biomarker if appropriate adjustment for full or residual kidney function and dietary meat intake is undertaken.

AB - Background: Higher muscle mass is associated with better outcomes and longevity in patients with chronic disease states. Imaging studies such as dual-energy X-ray absorptiometry (DEXA) are among the gold standard methods for assessing body fat and lean body mass (LBM), approximately half of which is comprised of skeletal muscle mass. Elaborate imaging devices, however, are not commonly available in routine clinical practice and therefore easily accessible and cost-effective, but reliable muscle mass biomarkers are needed. One such marker is serum creatinine, derived from muscle-based creatine, which is inexpensive and ubiquitously available, and it can serve as a biomarker of skeletal muscle mass in human subjects. Methods and results: In 118 hemodialysis patients, we found that the 3-month averaged serum creatinine concentration correlated well with DEXA-measured LBM. The recent literature regarding serum creatinine as a surrogate of muscle mass is summarized, as is the literature concerning the use of other measures of muscle mass, such as plasma gelsolin and actin, and urinary creatinine excretion. We have also reviewed the role of dietary meat intake in serum creatinine variability along with several biomarkers of dietary meat intake (creatine, carnitine, carnosine, ophidine, anserine, 3-methyl-l-histidine and 1-methylhistidine). Conclusion: In summary, none of these biomarkers was studied in CKD patients. We advance the hypothesis that in both health and disease, under steady state, serum creatinine can serve as a reliable muscle mass biomarker if appropriate adjustment for full or residual kidney function and dietary meat intake is undertaken.

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