ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: FR-PO468

Can We Use the Modified Creatinine Index for Assessment of Muscle Mass in Peritoneal Dialysis Patients?

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Szeto, Cheuk-Chun, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  • Chan, Gordon Ck, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  • Fung, Winston Ws, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  • Ng, Jack Kit-Chung, The Chinese University of Hong Kong, Hong Kong, Hong Kong

Sarcopenia is common in chronic dialysis patients and is associated with increased morbidity and mortality. The modified creatinine index (MCrI) is a simple that represents dietary protein intake and skeletal muscle mass, and has been found to be a reliable prognostic marker for chronic hemodialysis (HD) patients. Since single-pooled Kt/V (sp-Kt/V) for urea and pre-HD serum creatinine level for the calculation of MCrI, it remains unknown whether the index could be extrapolated to peritoneal dialysis (PD) patients.


We studied 138 patients (88 males) who were converted from PD to HD. We compared their MCrI measured within 6 months while on HD as computed by the standard formula and that computed by using the total weekly Kt/V and serum creatinine while the patient was on PD. The two parameters were compared by the Bland and Altman method.


The mean age was 50.9 ± 12.7 years; 82 patients (59.4%) were converted to HD because of severe or recurrent peritonitis, and 56 (40.6%) due to mechanical problems. The average MCrI during HD and PD were 22.21 ± 2.90 and 22.97 ± 3.24 mg/kg/day, respectively. The bias of using total weekly Kt/V and serum creatinine in PD for the calculation of MCrI was 0.758 mg/kg/day (95% confidence interval [CI] -4.356 to +5.873 mg/kg/day), or 4% (95%CI -20% to +28%). The difference in MCrI calculated during HD and PD significantly correlated with serum albumin (r=0.342, p<0.0001), and inversely with residual glomerular filtration rate (GFR) (r=-0.359, p<0.0001). MCrI during PD significantly correlated with the Charlson’s comorbidity index (r=-0.356, p<0.0001), serum albumin (r=0.315, p<0.0001), residual GFR (r=-0.362, p<0.0001), percentage of fat-free edema-free body mass by creatinine kinetics (r=0.684, p<0.0001), lean tissue mass by multi-frequency bioimpedance spectroscopy (r=0.641, p<0.0001), but not normalized protein nitrogen appearance (r=0.034, p=0.7) or adipose tissue mass (r=-0.146, p=0.17).


MCrI, when calculated by total weekly Kt/V and serum creatinine in PD, results in a small bias, but it remains significantly correlated with other measures of skeletal muscle mass. Further studies are needed to determine the prognostic value MCrI in PD patients.


  • Clinical Revenue Support