Studies on Creatinine Metabolism in Kwashiorkor and Marasmus

Abstract

VIN0DINI REDDY, MB. B.S. , D.C. H. C HILDREN suffering from kwashiorkor excrete low amounts of creatinine in unine’3 as do children suffering from � The increase in urinary creatinine following nutnitional recovery has been ascribed to increase in muscle mass.5 It has also been observed that an abrupt increase in urinary creatinine occurs during the first few days of therapy which cannot be explained on the basis of new muscle formation.4’5 Based upon their observations in patients with kwashiorkor that serum creatinine levels, although not high initially, decrease markedly during therapy-a decrease which parallels the increase in urinary creatinine-�Arroyave et al.3 have suggested that in the edematous phase of kwashiorkor, the renal capacity to eliminate creatinine may be reduced. The studies of Vinodini et al.4 on marasmic subjects in whom edema was absent have shown that even in these subjects there is a small but consistent increase of about 10 per cent in urinary creatinine within 48 hours after the institution of high protein diets. This would then suggest that factors other than renal are also involved in the pattern of creatinine excretion in protein-calorie deficient children. Studies on creatinine in blood and creatinine metabolism in undernourished children have been few. In the present study, levels of creatine, creatinine and its precursors, guanidineacetic acid and arginine, have been determined in the blood of subjects suffering from