Creatinine/Height Index

Excretion of creatinine correlates with muscle mass if renal function, nutrition and diet are normal. In protein-energy malnutrition, there is reduction in total body muscle mass, with a corresponding reduction in 24 hour urinary creatinine excretion. creatinine/height index (CHI) = = (mg creatinine in 24 hour urine from patient) / (mg creatinine in 24 hour urine from healthy adult control) * 100 where: The healthy control is of the same sex, age and height. expected 24 hour urine creatinine clearance = = (ideal body weight in kilograms) * (creatinine coefficient in mg/kg) where: For normal adult males, the creatinine coefficient = 23 mg/kg of ideal body weight. For women, the creatinine coefficient = 18 mg/kg of ideal body weight. Interpretation: Decreases in CHI are proportionate to the decrease in total body muscle mass. Muscle Mass Depletion mild CHI 80-90%

moderate severe

70-80% < 70%

References: Apelgren KN, Rombeau JL, et al. Comparison of nutritional indices and outcome in critically ill patients. Critical Care. 1982;10:305-307. Bistrian BR, Blackburn GL, et al. Therapeutic Index of Nutritional Depletion in Hospitalized Patients. Surgery, Gynecology and Obstetrics. 1975;141:512-516. Blackburn GL, Bistrian BR, et al. Nutritional and metabolic assessment of the hospitalized patient. J Parental Enteral Nutrition. 1977; 1:11-22. Veldee MS, Chapter 20: Nutrition, pages 1236-1274; IN: Burtis C, Ashwood E. Tietz Textbook of Clinical Chemistry, Second edition. W.B. Saunders Company. 1994.