THE CREATININE HEIGHT INDEX: ITS USE IN THE ESTIMATION OF THE DEGREE OF PROTEIN DEPLETION AND REPLETION IN PROTEIN CALORIE MALNOURISHED CHILDREN

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Abstract
The creatinine height index (CHI), which consists of the following ratio: CHI: 24 hour creatinine excretion of subject 24 hour creatinine excretion of normal child of same height has been devised for estimating the relative muscle mass of children. Age is not considered because children of developing areas are very often retarded in height. The normal CHI is close to 1.0, both in well nourished children and in fully recovered malnourished ones, with heights ranging from 64.8 to 135 cm. Protein calorie malnourished (PCM) children of the edematous type (kwashiorkor and kwashiorkormarasmus) had CHI's ranging from 0.25 to 0.75, lower CHI's were observed in more severely malnourished children and vice versa. In clinically marasmic children (PCM without edema) the CHI ranged from 0.33 to 0.85, independent of the degree of weight deficit or the clinical severity of marasmus, indicating that severe caloric deficiency can occur with a wide range of muscle wasting. No creatinine retention was observed in any PCM children with adequate urine flows. Independent estimates of protein and calorie repletion were obtained during recovery by the use of CHI and weight for height. A significant negative correlation between CHI and N retention was found, indicating the physiological significance of the CHI in estimating protein nutrition.

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