title: Creatinine as a measure of lean body mass during treatment of acute lymphoblastic leukemia in childhood.
abstract: Protein energy malnutrition is well-recognized in children with acute leukemia and may result in loss of lean body mass (LBM) with attendant morbidities. Much of the LBM consists of skeletal muscle, the mass of which is reflected in urinary creatinine excretion. As accurate 24 hours urine collections are challenging in children, we investigated the prospect that serum creatinine concentration provides a measure of LBM. Eleven children with acute lymphoblastic leukemia were assessed at 7 time points (6-mo intervals) from diagnosis to 1 year after the completion of therapy. LBM was measured as fat-free mass by dual energy x-ray absorptiometry (DXA scans) and correlated with serum creatinine concentration and 24 hours urine creatinine excretion. As expected, there was a strong correlation between 24 hours urinary creatinine excretion and LBM from DXA scans (r=0.79, P<0.001). Serum creatinine concentration also correlated with LBM (r=0.52, P<0.001). Serum creatinine concentration provides a surrogate measure of LBM in children with acute lymphoblastic leukemia. This will be especially useful in countries with limited resources in which more sophisticated measures, such as DXA scans, are seldom available.
authors.affiliation: McMaster Children's Hospital, Hamilton, Canada.
authors.forename: Judy
authors.initials: J
authors.lastname: Morrison
authors.forename: Trishana
authors.initials: T
authors.lastname: Nayiager
authors.forename: Colin E
authors.initials: CE
authors.lastname: Webber
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sala
authors.forename: Ronald
authors.initials: R
authors.lastname: Barr
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood / Q000627:therapeutic use / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D003404:Creatinine