THE CONCENTRATION OF CREATINE IN HEART, DIAPHRAGM, AND SKELETAL MUSCLE IN UREMIA

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Abstract
Creatine was detd. in diaphragm, heart and skeletal muscles of 26 patients with uremia. Despite creatine retention in uremia, creatine was reduced in all muscles studied. Congestive failure, diabetes and terminal acute infections appear to cause losses of creatine in excess of the possible increase in creatine from creatinine retention. Creatine losses in heart, diaphragm and voluntary muscles were not parallel, but extremely low creatine reserves in one muscle went with great reduction in others. Six diabetic patients who were also in failure showed the lowest figures for the entire series. Patients with enlarged compensated hearts had less marked losses of creatine in heart, diaphragm and skeletal muscles. Creatinine retention in uremia may be expected to cause retention of muscle creatine. 15 normal diaphragms were analyzed. Avg. creatine content was 234 mg.%. In chronic diseases and congestive failure, especially in diabetes, creatine was greatly reduced in the diaphragm as well as in other muscles.