Abstract
OBJECTIVE Fasting is not routinely recommended for renal function tests, despite the known effects
of cooked meat on creatinine. We therefore studied variation in creatinine and estimate glomerular
filtration rate (eGFR) following a standardised cooked meat meal in 80 subjects: healthy volunteers,
diabetes patients with chronic kidney disease (CKD) stages 1 & 2, 3A, 3B and 4 (n=16/group).
RESEARCH DESIGN AND METHODS The interventions were a standardised cooked meat and a nonmeat meal, each providing approximately 54g protein, together with 250 mls of water, on separate
days. Fasting and post-prandial blood samples at 1, 2, and 4 hours were drawn for creatinine
measurement using kinetic alkaline picrate assay on an Olympus AU640 analyser. The modified 4-
variable MDRD equation traceable to isotope dilution mass spectrometry creatinine was used to
calculate eGFR.
RESULTS Consumption of a standardised cooked meat meal significantly increased serum creatinine
and resulted in significant fall in eGFR in all stages of CKD studied; 6 of 16 CKD 3a patients were
misclassified as CKD 3b. This effect of cooked meat on serum creatinine disappears after 12 hours of
fasting in all study participants.
CONCLUSIONS Creatine in meat is converted to creatinine on cooking which is absorbed causing
significant increases in serum creatinine. This could impact management as threshold for
commencing and withdrawing certain medications and expensive investigations is defined by eGFR.
eGFR calculated using fasting serum creatinine would be a better reflection of kidney function in
these patients.
Original language | English |
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Pages (from-to) | 483-487. |
Number of pages | 4 |
Journal | Diabetes Care |
Volume | 37 |
Issue number | 2 |
DOIs | |
Publication status | Published - 2014 |
Keywords
- Diabetes
- kidney disease