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• W2915695919 abstract "To the Editor: I am writing to comment on the interesting work of Feinfeld et al. entitled, “Sequential Changes in Renal Function Tests in the Old, Old: Results from the Bronx Longitudinal Aging Study”.1 These investigators studied 461 volunteers with a mean age of 79 years and found a mean creatinine value of 1.27 mg/dL. Two years later, 295 subjects were studied and the mean creatinine was 1.10 mg/dL. The authors state, “actual longitudinal improvement in renal function tests is an unexpected finding.” In a medically stable individual, the serum creatinine value is the result of a balance between muscle mass and glomerular filtration rate. Twenty-four-hour urine creatinine excretion is often used to estimate muscle mass. The Cockroft-Gault estimate for creatinine clearance is based on the assumption that one can estimate 24-hour creatinine excretion (muscle mass) from age and weight and sex.2 In the discussion, the authors state that, “Muscle mass probably did not change because BMI was unchanged.” I believe that more data would be required to make such an assumption given previous reports of a shift from muscle toward fat with aging.3 Another possible explanation for the findings of Feinfeld et al. is that 166 individuals were studied initially who were not part of the final data set with lower serum creatinine values. It is possible that those with higher creatinine values carried a higher disease burden and either died, were too frail, and/or lacked the vitality to return for testing 2 years later. This mechanism could be probed by comparing creatinine values at Year 1 with those of Year 3 in only the 295 individuals who returned for the determination at Year 3. I believe that it is important that clinicians consider that the serum creatinine is a measure of muscle mass andglomerular filtration rate. The clinician who uses the serum creatinine as a reflection of kidney function should make a clinical assessment of muscle mass." @default.
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• W2915695919 date "1995-11-01" @default.
• W2915695919 modified "2023-09-26" @default.
• W2915695919 title "SEQUENTIAL CHANGES IN RENAL FUNCTION TESTS IN THE OLD, OLD: RESULTS FROM THE BRONX LONGITUDINAL AGING STUDY" @default.
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• W2915695919 doi "https://doi.org/10.1111/j.1532-5415.1995.tb07420.x" @default.
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