The response to stress as happens in severe injury or illness is a
catabolic state. This results in loss of lean body mass and a worsening
physical state.
It is essential that there is adequate nutritional support with protein
and energy during this crisis.
Catabolism results in the release of amino acids which are metabolised
to end products including urea. There is also the release of intercellular
products including potassium, phosphate and magnesium. Arginine oxidation
is reflected in creatinine production.
Carlotti et al in QJMed have looked at whether there is an increased rate of creatinine urinary excretion with the catabolic state in children who had experienced severe trauma. They related this to balances of potassium, phosphate and magnesium to evaluate the benefit of nutritional therapy during this crisis.
They concluded that negative balances of intracellular components (potassium, phosphate and magnesium ) and an increase in rate of creatinine excretion heralded the onset of catabolism
Carlotti et al 2008 Indicators of lean body mass catabolism: emphasis
On the creatinine excretion rate QJ Med vol 101, 197-205

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