Serum creatinine level, a surrogate of muscle mass, predicts mortality in critically ill patients
Serum creatinine level, a surrogate of muscle mass, predicts mortality in critically ill patients
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DOI：
10.21037/jtd.2016.03.62
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发表时间：
2016-05-01
影响因子：
2.5
通讯作者：
Kashani, Kianoush
中科院分区：
文献类型：
--
作者：
Thongprayoon, Charat;Cheungpasitporn, Wisit;Kashani, Kianoush
血清肌酐(Scr)已被广泛用于估计肾小球滤过率(GFR)。在低骨骼肌质量的情况下，肌酐的生成可能会减少。因此，Scr也被用作肌肉质量的替代品。在住院患者中，尤其是在重症监护病房(ICU)环境中，肌肉质量低与生存率降低有关。最近的研究表明，入院时Scr水平较低的ICU患者死亡率较高，这反映了低肌肉质量或营养不良与死亡率的增加有关。然而，Scr水平也可能受到多种GFR相关和非GFR相关因素的影响，包括年龄、饮食、运动、压力、怀孕和肾脏疾病。成像技术，如计算机断层扫描(CT)和超声，最近已被研究用于肌肉质量评估，并展示了有希望的数据。本文旨在介绍SCR和其他方法在预测ICU患者肌肉质量和预后方面的应用前景。
Serum creatinine (SCr) has been widely used to estimate glomerular filtration rate (GFR). Creatinine generation could be reduced in the setting of low skeletal muscle mass. Thus, SCr has also been used as a surrogate of muscle mass. Low muscle mass is associated with reduced survival in hospitalized patients, especially in the intensive care unit (ICU) settings. Recently, studies have demonstrated high mortality in ICU patients with low admission SCr levels, reflecting that low muscle mass or malnutrition, are associated with increased mortality. However, SCr levels can also be influenced by multiple GFR- and non-GFR-related factors including age, diet, exercise, stress, pregnancy, and kidney disease. Imaging techniques, such as computed tomography (CT) and ultrasound, have recently been studied for muscle mass assessment and demonstrated promising data. This article aims to present the perspectives of the uses of SCr and other methods for prediction of muscle mass and outcomes of ICU patients.