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      Body Composition Analysis Allows the Prediction of Urinary Creatinine Excretion and of Renal Function in Chronic Kidney Disease Patients

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          Abstract

          The aim of this study was to predict urinary creatinine excretion (UCr), creatinine clearance (CCr) and the glomerular filtration rate (GFR) from body composition analysis. Body cell mass (BCM) is the compartment which contains muscle mass, which is where creatinine is generated. BCM was measured with body impedance analysis in 165 chronic kidney disease (CKD) adult patients (72 women) with serum creatinine (SCr) 0.6–14.4 mg/dL. The GFR was measured ( 99mTc-DTPA) and was predicted using the Modification of Diet in Renal Disease (MDRD) formula. The other examined parameters were SCr, 24-h UCr and measured 24-h CCr (mCCr). A strict linear correlation was found between 24-h UCr and BCM ( r = 0.772). Multiple linear regression (MR) indicated that UCr was positively correlated with BCM, body weight and male gender, and negatively correlated with age and SCr. UCr predicted using the MR equation (MR-UCr) was quite similar to 24-h UCr. CCr predicted from MR-UCr and SCr (MR-BCM-CCr) was very similar to mCCr with a high correlation ( r = 0.950), concordance and a low prediction error (8.9 mL/min/1.73 m 2). From the relationship between the GFR and the BCM/SCr ratio, we predicted the GFR (BCM GFR). The BCM GFR was very similar to the GFR with a high correlation ( r = 0.906), concordance and a low prediction error (12.4 mL/min/1.73 m 2). In CKD patients, UCr, CCr and the GFR can be predicted from body composition analysis.

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          Most cited references31

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          Prediction of Creatinine Clearance from Serum Creatinine

          A formula has been developed to predict creatinine clearance (C cr ) from serum creatinine (S cr ) in adult males: Ccr = (140 – age) (wt kg)/72 × S cr (mg/100ml) (15% less in females). Derivation included the relationship found between age and 24-hour creatinine excretion/kg in 249 patients aged 18–92. Values for C cr were predicted by this formula and four other methods and the results compared with the means of two 24-hour C cr’s measured in 236 patients. The above formula gave a correlation coefficient between predicted and mean measured Ccr·s of 0.83; on average, the difference between predicted and mean measured values was no greater than that between paired clearances. Factors for age and body weight must be included for reasonable prediction.
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            A concordance correlation coefficient to evaluate reproducibility.

            L Lin (1989)
            A new reproducibility index is developed and studied. This index is the correlation between the two readings that fall on the 45 degree line through the origin. It is simple to use and possesses desirable properties. The statistical properties of this estimate can be satisfactorily evaluated using an inverse hyperbolic tangent transformation. A Monte Carlo experiment with 5,000 runs was performed to confirm the estimate's validity. An application using actual data is given.
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              Comparing correlated correlation coefficients.

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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                28 May 2017
                June 2017
                : 9
                : 6
                : 553
                Affiliations
                Department of Clinical and Experimental Medicine, Division of Nephrology, University of Pisa, I-56100 Pisa, Italy; carlo.donadio@ 123456med.unipi.it ; Tel.: +39-050-99-7278
                Article
                nutrients-09-00553
                10.3390/nu9060553
                5490532
                28555040
                356365db-da96-4bdf-b15d-1b732334f75f
                © 2017 by the author.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 February 2017
                : 23 May 2017
                Categories
                Article

                Nutrition & Dietetics
                glomerular filtration rate,24-h urinary creatinine excretion,creatinine clearance,estimate of renal function,body composition analysis,body cell mass,electrical body impedance

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