Dear Rakesh,
Greetings from Al-Ain the oasis city. You might find the following of some
relevence to your above posting.
Nakao T. Characteristics of the patients with diabetic nephropathy with
relatively low serum creatinine at the initiation of dialysis. Nippon Jinzo
Gakkai Shi 1990 Sep;32(9):1025-31 (In Japanese)
Clinical feature and creatinine metabolism were studied in 86 diabetic
patients who had newly initiated dialysis treatment. In 32.5% of the
patients, serum creatinine was below 8.0 mg/dl at the initiation of dialysis
treatment. Gastrointestinal symptoms, general malaise, pulmonary edema and
uremic encephalopathy were the causes which required dialysis treatment in
those patients, and the frequency of pulmonary edema was significantly
higher than in patients whose serum creatinine was above 8.0 mg/dl at the
initiation of dialysis (p less than 0.05). There were no significant
differences in serum urea nitrogen, potassium, sodium, albumin levels and
hematocrit between low serum creatinine group (3.0-7.9 mg/dl) and high serum
creatinine group (8.0-11.9 mg/dl) at the initiation of dialysis. Serum
creatinine levels were highly correlated with creatinine generation rate (r
= 0.788, p greater than 0.01). There was a significant correlation between
creatinine generation rate and muscle volume (r = 0.863, p less than 0.001).
Muscle volume of diabetic dialyzed patients was 29.5 +/- 7.0 cm3/cm in males
and 26.9 +/- 5.0 cm3/cm in females, and those values were lower than those
of non-diabetic dialyzed patients (p greater than 0.005). Frequency of the
patients whose creatinine generation rate was below 1500 mg/day was 81.3% in
diabetic hemodialyzed patients and this was significantly higher than in
non-diabetic hemodialyzed patients (p less than 0.005).
In conclusion, in patients with diabetic nephropathy who have to initiate
dialysis treatment, uremic symptoms have progressed though serum creatinine
levels are relatively low. This low serum creatinine levels in patients with
diabetic end-stage renal disease are resulted from their low muscle volume.
http://www.emedicine.com/NEURO/topic388.htm
This article on e medicine might also be of some interest.
Hope this is of some help.
Cheers & regards,
Badri
Dr.P.Badrinath M.D,M.Phil,(Epid)PhD(Cantab)DFPHM(UK),MPH(Distinc)
Clinical Assistant Professor & Hon Consultant in Preventive Medicine,
Department of Community Medicine,
UAE University, PO Box 17666, Al Ain,
United Arab Emirates.
Tel: 00 971 3 7039 652
Fax: 00 971 3 7672022.
http://myprofile.cos.com/badrishanthi
"For an excellent review of the current medical literature, go to Journals
Scan www.uaeu.ac.ae/jscan/" - BMJ 3rd June 2000, Netlines
_________________________________________________________________
MSN Photos is the easiest way to share and print your photos:
http://photos.msn.com/support/worldwide.aspx
|