Decrease in urinary creatinine excretion in early stage chronic kidney disease

Détails

ID Serval
serval:BIB_ED64B28DDA22
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Decrease in urinary creatinine excretion in early stage chronic kidney disease
Périodique
PLoS One
Auteur⸱e⸱s
Tynkevich E., Flamant M., Haymann J. P., Metzger M., Thervet E., Boffa J. J., Vrtovsnik F., Houillier P., Froissart M., Stengel B.
Collaborateur⸱rice⸱s
NephroTest Study Group
ISSN
1932-6203 (Electronic))
ISSN-L
1932-6203
Statut éditorial
Publié
Date de publication
2014
Volume
9
Numéro
11
Pages
e111949
Langue
anglais
Notes
Tynkevich, Elena
Flamant, Martin
Haymann, Jean-Philippe
Metzger, Marie
Thervet, Eric
Boffa, Jean-Jacques
Vrtovsnik, Francois
Houillier, Pascal
Froissart, Marc
Stengel, Benedicte
eng
Research Support, Non-U.S. Gov't
2014/11/18 06:00
PLoS One. 2014 Nov 17;9(11):e111949. doi: 10.1371/journal.pone.0111949. eCollection 2014.
Résumé
BACKGROUND: Little is known about muscle mass loss in early stage chronic kidney disease (CKD). We used 24-hour urinary creatinine excretion rate to assess determinants of muscle mass and its evolution with kidney function decline. We also described the range of urinary creatinine concentration in this population. METHODS: We included 1072 men and 537 women with non-dialysis CKD stages 1 to 5, all of them with repeated measurements of glomerular filtration rate (mGFR) by (51)Cr-EDTA renal clearance and several nutritional markers. In those with stage 1 to 4 at baseline, we used a mixed model to study factors associated with urinary creatinine excretion rate and its change over time. RESULTS: Baseline mean urinary creatinine excretion decreased from 15.3 +/- 3.1 to 12.1 +/- 3.3 mmol/24 h (0.20 +/- 0.03 to 0.15 +/- 0.04 mmol/kg/24 h) in men, with mGFR falling from >/= 60 to <15 mL/min/1.73 m(2), and from 9.6 +/- 1.9 to 7.6 +/- 2.5 (0.16 +/- 0.03 to 0.12 +/- 0.03) in women. In addition to mGFR, an older age, diabetes, and lower levels of body mass index, proteinuria, and protein intake assessed by urinary urea were associated with lower mean urinary creatinine excretion at baseline. Mean annual decline in mGFR was 1.53 +/- 0.12 mL/min/1.73 m(2) per year and that of urinary creatinine excretion rate, 0.28 +/- 0.02 mmol/24 h per year. Patients with fast annual decline in mGFR of 5 mL/min/1.73 m(2) had a decrease in urinary creatinine excretion more than twice as big as in those with stable mGFR, independent of changes in urinary urea as well as of other determinants of low muscle mass. CONCLUSIONS: Decrease in 24-hour urinary creatinine excretion rate may appear early in CKD patients, and is greater the more mGFR declines independent of lowering protein intake assessed by 24-hour urinary urea. Normalizing urine analytes for creatininuria may overestimate their concentration in patients with reduced kidney function and low muscle mass.
Mots-clé
Age Factors, Body Mass Index, Creatinine/*urine, Ethnic Groups, Female, *Glomerular Filtration Rate, Humans, Kidney Function Tests, Male, Muscle, Skeletal/pathology, Organ Size, Prospective Studies, Renal Insufficiency, Chronic/pathology/*physiopathology, Risk Factors, Sex Factors
Pubmed
Open Access
Oui
Création de la notice
03/03/2016 17:48
Dernière modification de la notice
14/11/2019 16:04
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