It is known that there is a change in creatine and creatinine metabolism in muscular dystrophy which causes creatinuria and decreased creatinine excretion. Why this change occurs is still open to speculation. It can be accepted that the lowered creatinine excretion is due to degeneration of the muscle fibers, for Shaffer1 showed that the creatinine excretion is an index of muscular development. An explanation for the presence of creatinuria is more difficult. The breakdown of the muscle causing the liberation of creatine is one explanation that has been offered. This does not appear feasible because the relatively small amounts that would be liberated in the breakdown of the muscle fibers could not account for the large quantity of creatine excreted over a period of years. An explanation that appears to be more logical is that creatine is being formed at a slower rate than normal, and due to the
MAGEE MC. CREATINE AND CREATININE METABOLISM IN PROGRESSIVE MUSCULAR DYSTROPHY: REPORT OF TWO CASES AND CONTROLS. Am J Dis Child. 1932;43(1):19–31. doi:10.1001/archpedi.1932.01950010026003
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