2021
DOI: 10.1097/mcc.0000000000000842
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Novel methods to identify and measure catabolism

Abstract: Purpose of review Assess current potential catabolism-biomarkers to characterize patients developing prolonged critical illness. Recent findingsA raised urea-to-creatinine ratio (UCR) during critical illness is negatively associated with muscle mass with greater increases in UCR seen patients developing persistent critical illness. Similarly, sarcopenia index (a ratio of creatinine to cystatin-c concentrations) correlates well to muscle mass in intensive care populations. Elevated growth/differentiation factor… Show more

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Cited by 9 publications
(10 citation statements)
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“…Recognition of the transition between catabolic and anabolic phase following critical illness is of great interest, as it can trigger pharmacological strategies or changes in physical exercises and nutritional strategies [ 20 ]. Urea-to-creatinine ratio and the creatinine-to-cystatin C ratio (known as the sarcopenia index) are both potential biomarkers of catabolism, as they were correlated to muscle mass [ 21 ]. However, they are not suitable for assessment in case of concomitant acute kidney injury or renal replacement therapy, two situations frequently encountered in the ICU and post-ICU context.…”
Section: Discussionmentioning
confidence: 99%
“…Recognition of the transition between catabolic and anabolic phase following critical illness is of great interest, as it can trigger pharmacological strategies or changes in physical exercises and nutritional strategies [ 20 ]. Urea-to-creatinine ratio and the creatinine-to-cystatin C ratio (known as the sarcopenia index) are both potential biomarkers of catabolism, as they were correlated to muscle mass [ 21 ]. However, they are not suitable for assessment in case of concomitant acute kidney injury or renal replacement therapy, two situations frequently encountered in the ICU and post-ICU context.…”
Section: Discussionmentioning
confidence: 99%
“…Since creatinine formation is spontaneous and nonenzymatic, its levels are related to muscle mass. Therefore, serum creatinine is a common surrogate for muscle activity and mass [ 29 , 30 , 31 , 32 ]. The higher circulating creatinine in the thiamine-treated groups may potentially indicate an increased muscle mass or metabolic activity.…”
Section: Discussionmentioning
confidence: 99%
“…The measurement may not be feasible in all units and with all patients such as those on CRRT (further investigation needed). Alternatively, the urea‐to‐creatinine ratio represents a practical biomarker for monitoring catabolism and, thus, the adequacy of protein supply 70,71 . Moreover, monitoring of the protein target vs actual intake via MNT (nutritional adequacy) should be implemented in routine clinical practice to improve overall performance (Table 1).…”
Section: Guidance For Improving Nutritional Adequacymentioning
confidence: 99%
“…A promising biomarker, the urea-to-creatinine ratio, represents an accessible and practical tool to evaluate and monitor catabolism, and thereby, the adequacy of protein supply in routine clinical practice (Table 1). 70,71…”
Section: Definition Of Protein Goalsmentioning
confidence: 99%