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Estimation of protein intake using urinary urea nitrogen in patients with early-stage liver cirrhosis.

ABSTRACT: PURPOSE: Evaluation of protein intake of patients with liver cirrhosis (LC) would facilitate optimal nutritional support. However, it has never been done on the basis of urinary urea nitrogen (UUN). The aim of this study, therefore, is to determine the usefulness of the estimated protein intake (EPI) based on UUN in patients with LC. METHODS: A total of 42 patients with early-stage LC were enrolled in this study. The actual protein intake (API) was defined as the dietary protein intake (1.0 g/kg/d) plus supplementation of any enteral diets containing branched-chain amino acids (BCAA). We calculated EPI from UUN using the formula [UUN (g/d) + 0.031 x body weight (kg)] x 0.625. We examined the correlation between EPI and API, the EPI/API ratio (EAR), and the correction based on the results. RESULTS: A significant positive correlation was found between API and EPI (r = 0.703, p < 0.001). The EAR in all patients was 0.84 +/- 0.11. EPI times 1.2 was the correction needed to adjust EAR to 1. The corrected EPI was correlated with API (r = 0.704, p < 0.001). The corrected EAR of all 42 patients was 1.01 +/- 0.13. CONCLUSION: In conclusion, for patients with early-stage LC, an EPI calculated from UUN may be a useful tool for optimal nutritional support. The corrected EPI would be very useful for improved monitoring of early-stage LC.

SUBMITTER: Kida Y

PROVIDER: S-EPMC2716834 | biostudies-other | 2007 Sep

REPOSITORIES: biostudies-other

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Project description:We examined whether escalating doses of potassium bicarbonate (KHCO3) supplements alter urinary nitrogen excretion expressed as a ratio to same day nitrogen intake (measure of muscle-protein breakdown). The ratio declined significantly from placebo to low to high dose of KHCO3 supplementation in older adults over 3 months, suggesting muscle-sparing.IntroductionNeutralization of dietary acid load with alkali supplementation (i.e., KHCO3) has been hypothesized to have muscle protein-sparing effects. In controlled feeding studies with fixed nitrogen (N) intake/day, 24-h urinary N excretion is a good marker of muscle breakdown. However, in studies with self-selected diets, changes in 24-h urinary N excretion can be influenced by shifts in N intake.MethodsWe evaluated changes in 24-h total urinary N excretion as a ratio of N excretion to concurrent N intake in 233 older men and women who participated in an 84-day KHCO3 supplementation randomized placebo-controlled trial.ResultsAfter adjustment for relevant cofactors, escalating doses of KHCO3 (1 mmol/kg/day [low] or 1.5 mmol/kg/day [high]) resulted in a progressive decline in urinary N excretion/N intake compared to placebo (overall P for trend = 0.042). The 84-day change in urinary N excretion/N intake in the high-dose KHCO3 group was statistically significantly lower compared to placebo (P = 0.012) but not compared to the low-dose KHCO3 group (P = 0.276). The 84-day change in urinary N excretion/N intake in the low-dose KHCO3 group did not differ significantly from placebo (P = 0.145).ConclusionsUrinary N excretion expressed as ratio to same day N intake declined steadily with increasing doses of KHCO3 supplementation from low 1 mmol/kg/day to high 1.5 mmol/kg/day, suggesting a nitrogen-sparing effect. Compared to urinary N excretion alone, this ratio could be a more reasonable measure of muscle protein metabolism in large-scale long-term human studies.Trial registrationClinicaltrials.gov NCT1475214.

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Estimation of protein intake using urinary urea nitrogen in patients with early-stage liver cirrhosis.

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