title: Creatinine index as a surrogate of lean body mass derived from urea Kt/V, pre-dialysis serum levels and anthropometric characteristics of haemodialysis patients.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nephrology, Dialysis and Intensive Care Unit, CHRU, Montpellier, France; Dialysis Research and Training Institute, Montpellier, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Canaud
authors.affiliation: Nephrology, Dialysis and Intensive Care Unit, CHRU, Montpellier, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Granger Vallée
authors.affiliation: UMR 729 MISTEA, DIM, CHRU, Montpellier, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Molinari
authors.affiliation: Nephrology, Dialysis and Intensive Care Unit, CHRU, Montpellier, France; Dialysis Research and Training Institute, Montpellier, France.
authors.forename: Leila
authors.initials: L
authors.lastname: Chenine
authors.affiliation: Nephrology, Dialysis and Intensive Care Unit, CHRU, Montpellier, France; Dialysis Research and Training Institute, Montpellier, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Leray-Moragues
authors.affiliation: Dialysis Research and Training Institute, Montpellier, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: AIDER, Montpellier, France.
authors.forename: Lotfi
authors.initials: L
authors.lastname: Chalabi
authors.affiliation: Dialysis Research and Training Institute, Montpellier, France; Biochemistry Laboratory, CHRU, Montpellier, France; UMR 204, University of Montpellier I, Montpellier, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Morena
authors.affiliation: Dialysis Research and Training Institute, Montpellier, France; Biochemistry Laboratory, CHRU, Montpellier, France; UMR 204, University of Montpellier I, Montpellier, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cristol
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000473:pathology / Q000628:therapy; D014508:Urea / Q000097:blood*
chemical_list: D015415:Biomarkers; D014508:Urea; D003404:Creatinine