Creatinine index as a surrogate of lean body mass derived from urea Kt/V, pre-dialysis serum levels and anthropometric characteristics of haemodialysis patients.
Creatinine index as a surrogate of lean body mass derived from urea Kt/V, pre-dialysis serum levels and anthropometric characteristics of haemodialysis patients.
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DOI：
10.1371/journal.pone.0093286
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Cristol JP
中科院分区：
文献类型：
--
作者：
Canaud B;Granger Vallée A;Molinari N;Chenine L;Leray-Moragues H;Rodriguez A;Chalabi L;Morena M;Cristol JP
蛋白质能量浪费在慢性肾脏疾病长期血液透析(HD)患者中很常见，并与发病率和死亡率的增加有关。肌酐指数(CI)是反映患者膳食中骨骼肌蛋白摄入量和骨骼肌质量的一种简单实用的营养参数。由于肌酐动力学模型(CKM)推导CI的复杂性，我们开发了一个更简单的公式来估计HD患者的CI。对549名HD患者进行了20多年的跟踪调查，其中包括每月CKM得出的CI值，利用混合回归模型，根据患者的人口学数据、透析前的血肌酸值和透析剂量(spKt/V)，建立了一个简单的方程。根据年龄、性别、透析前血肌酐浓度和SpKt/V尿素建立CI估计式。方程导出的CI与使用CKM测量的CI有很强的相关性(相关系数 = 为0.79，p值为0.001)。用该方程预测CI的平均误差为13.47%。一些典型的HD患者的初步例子已经被用来说明CI的临床相关性和潜在的实用性。使用人口统计学参数、透析前血清肌酐浓度和透析剂量来得出CI的基本方程是一种简单而准确的肌肉质量估计的替代测量方法。然而，简化的CI评估方法对死亡率的预测价值值得在大量HD患者中进一步评估。
Protein-energy wasting is common in long-term haemodialysis (HD) patients with chronic kidney disease and is associated with increased morbidity and mortality. The creatinine index (CI) is a simple and useful nutritional parameter reflecting the dietary skeletal muscle protein intake and skeletal muscle mass of the patient. Because of the complexity of creatinine kinetic modeling (CKM) to derive CI, we developed a more simplified formula to estimate CI in HD patients. A large database of 549 HD patients followed over more than 20 years including monthly CKM-derived CI values was used to develop a simple equation based on patient demographics, predialysis serum creatinine values and dialysis dose (spKt/V) using mixed regression models. The equation to estimate CI was developed based on age, gender, pre-dialysis serum creatinine concentrations and spKt/V urea. The equation-derived CI correlated strongly with the measured CI using CKM (correlation coefficient = 0.79, p-value <0.001). The mean error of CI prediction using the equation was 13.47%. Preliminary examples of few typical HD patients have been used to illustrate the clinical relevance and potential usefulness of CI. The elementary equation used to derive CI using demographic parameters, pre-dialysis serum creatinine concentrations and dialysis dose is a simple and accurate surrogate measure for muscle mass estimation. However, the predictive value of the simplified CI assessment method on mortality deserves further evaluation in large cohorts of HD patients.
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DOI：
10.2215/cjn.02080310
发表时间：
2010-12-01
影响因子：
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作者：
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通讯作者：
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