Creatine homeostasis and protein energy wasting in hemodialysis patients
Post A, Schutten JC, Kremer D, van der Veen Y, Groothof D, Sotomayor CG, Koops CA, de Blaauw P, Kema IP, Westerhuis R, Wallimann T, Heiner-Fokkema MR, Bakker SJL, Franssen CFM
Journal of translational medicine · 12 citas
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Cómo se estudió
- Diseño
- Estudio transversal (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2021-03-20 · J Transl Med · vol. 19 · número 1 · pág. 115
- Editorial
- BioMed Central
- Citado
- 70 citas · más que el 99% de estudios similares · 8.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 75 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Dialysis and Renal Disease Management · Muscle metabolism and nutrition · Muscle and Compartmental Disorders
- Palabras clave
- Hypoalbuminemia, Creatine, Hemodialysis, Internal medicine, Creatinine, Endocrinology, Medicine, Arginine, Wasting, Creatine Monohydrate, Chemistry, Biochemistry, Pathology, Amino acid
- MeSH
- humans, creatine, creatinine, renal dialysis, homeostasis, aged, aged, 80 and over, middle aged, female, male
14 autores
- Adrian Post🇳🇱 · autor de correspondenciaUniversity Medical Center Groningen; University of Groningen
- Joëlle C. Schutten🇳🇱University Medical Center Groningen; University of Groningen
- Daan Kremer🇳🇱University Medical Center Groningen; University of Groningen
- Yvonne van der Veen🇳🇱University Medical Center Groningen; University of Groningen
- Dion Groothof🇳🇱University Medical Center Groningen; University of Groningen
- Camilo G. Sotomayor🇳🇱University Medical Center Groningen; University of Groningen
- Christa A. Koops🇳🇱University Medical Center Groningen; University of Groningen
- Pim de Blaauw🇳🇱University Medical Center Groningen; University of Groningen
- Ido P. Kema🇳🇱University Medical Center Groningen; University of Groningen
- Ralf Westerhuis🇳🇱Dialyse Centrum Groningen
- Theo Wallimann🇨🇭ETH Zurich
- Margaretha Rebecca Heiner-Fokkema🇳🇱University Medical Center Groningen; University of Groningen
- Stephan J. L. Bakker🇳🇱University Medical Center Groningen; University of Groningen
- Casper F. M. Franssen🇳🇱University Medical Center Groningen; University of Groningen
Resumen
El texto original del estudio, en el idioma en que se publicó.
Muscle wasting, low protein intake, hypoalbuminemia, low body mass, and chronic fatigue are prevalent in hemodialysis patients. Impaired creatine status may be an often overlooked, potential contributor to these symptoms. However, little is known about creatine homeostasis in hemodialysis patients. We aimed to elucidate creatine homeostasis in hemodialysis patients by assessing intradialytic plasma changes as well as intra- and interdialytic losses of arginine, guanidinoacetate, creatine and creatinine. Additionally, we investigated associations of plasma creatine concentrations with low muscle mass, low protein intake, hypoalbuminemia, low body mass index, and chronic fatigue. Arginine, guanidinoacetate, creatine and creatinine were measured in plasma, dialysate, and urinary samples of 59 hemodialysis patients. Mean age was 65 ± 15 years and 63% were male. During hemodialysis, plasma concentrations of arginine (77 ± 22 to 60 ± 19 μmol/L), guanidinoacetate (1.8 ± 0.6 to 1.0 ± 0.3 μmol/L), creatine (26 [16-41] to 21 [15-30] μmol/L) and creatinine (689 ± 207 to 257 ± 92 μmol/L) decreased (all P < 0.001). During a hemodialysis session, patients lost 1939 ± 871 μmol arginine, 37 ± 20 μmol guanidinoacetate, 719 [399-1070] μmol creatine and 15.5 ± 8.4 mmol creatinine. In sex-adjusted models, lower plasma creatine was associated with a higher odds of low muscle mass (OR per halving: 2.00 [1.05-4.14]; P = 0.04), low protein intake (OR: 2.13 [1.17-4.27]; P = 0.02), hypoalbuminemia (OR: 3.13 [1.46-8.02]; P = 0.008) and severe fatigue (OR: 3.20 [1.52-8.05]; P = 0.006). After adjustment for potential confounders, these associations remained materially unchanged. Creatine is iatrogenically removed during hemodialysis and lower plasma creatine concentrations were associated with higher odds of low muscle mass, low protein intake, hypoalbuminemia, and severe fatigue, indicating a potential role for creatine supplementation.
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