부산대학교 도서관

Calculated nitrogen balance in hemodialysis patients: Influence of protein intake. Background. Optimal nutrient intake is important in the maintenance of a positive nitrogen balance in hemodialysis (HD) patients. The objectives of this study were (1 ) to assess the influence of two levels of protein intakes on nitrogen balance in stable adult HD patients, and (2 ) to identify a minimum level of protein intake that would result in a negative nitrogen balance, so that preliminary recommendations may be made in Indian patients on maintenance HD (MHD). Methods. Stable, adult, nondiabetic MHD patients were recruited after informed consent into a cross over trial with a high-protein (HP) diet [1.2 g/kg ideal body weight (IBW)/day), followed by a low-protein (LP) diet (0.6 g/kg IBW/day] after appropriate periods of equilibration; for both diets, 50% of protein was of high biological value, and calorie intake was 35 kCal/kg IBW/day. Duplicate meals and residues were weighed, homogenized, and stored at -20°C for analysis of dietary N by the Kjeldahl method, used to check the consistency of the N content of the diet supplied. Pre- and post- (30-minute equilibrated) blood urea samples were drawn, and details of weights and other HD parameters were recorded. Interdialytic urine collections for urea were obtained. N input came from dietary protein calculated as 16% of the weight of biological protein; N output was calculated using blood-side urea measurements and urinary urea excretion and was the sum of urea N (UN) and nonurea N (NUN) losses (assumed to be equal to 0.031 g N/kg/day). Results. Fifteen patients were recruited. Twelve patients completed both limbs of the study. The mean age was 30.3 ± 12.7 years. The body mass index was 18.9 ± 2.4. Serum albumin was 3.8 ± 0.35 g/dL, and Kt/V (equilibrated) was 1.17 ± 0.3 g/dL. Protein consumed was 1.06 ± 0.18 g/kg IBW/day in the HP limb versus 0.61 ± 0.1 g/kg IBW/day in the LP limb (P =... [ABSTRACT FROM AUTHOR]