The body’s reaction to the illness (trauma, burns, inflammation, or surgery) includes an increase of energetic metabolism, hypersecretion of counter-regulatory hormones (glucagon, glucocorticoids, and catecholamines), and release of inflammatory mediators and other hormonal mediators (vasopressin) in the general setting of inflammation. Timely initiation of optimal nutritional support is important to slow the catabolic process and minimize adverse events such as prolonged mechanical ventilation, longer ICU stay, and increased risk of death.
Unfortunately, critical illness is characterized by hypermetabolic and hypercatabolic states, which leads to an elevated resting energy expenditure rate, hyperglycaemia, altered substrate use, and increased oxygen consumption.Īmong the patients who are previously well nourished before intensive care unit (ICU) admission, nutritional disorders develop rapidly because of the metabolic demands of illness, rapid fluid shifts, and the loss of specific vitamins and trace elements. Skeletal muscle places a vital role in regulating immune function, glucose disposer, protein synthesis, and mobility. The present chapter details the existing evidence related to the effects of nutritional status and muscle wasting on serum creatinine based on recent evidences. Despite these limits, serum creatinine is still considered the standard for assessing acute changes in renal function. There are no data available regarding its effect on serum creatinine, and moreover, ICU-acquired myopathy is rarely recognized because of insufficient diagnostic criteria or methodological limitations.
In addition, few studies have demonstrated the effect of muscle wasting on serum creatinine. Several studies had shown the reduced survival rates and the increased hospital lengths of stay of patients who have a poor nutrition status and low muscle mass.
This massive dynamic reservoir of proteins, minerals, and other metabolites could be cannibalized, and a loss of skeletal muscle may predispose impaired tissue hailing and few poor immune functions.
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