Urinary nitrogen excretion at the early stage of severe acute pancreatitis

2020 ◽  
Vol 21 (4) ◽  
pp. 131-134
Author(s):  
O. G. Sivkov ◽  
◽  
A. O. Sivkov ◽  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Early Stage ◽  
Ideal Body Weight ◽  
Nitrogen Excretion ◽  
The Third ◽  
Ideal Body ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen ◽  
The Ideal

Aim. To study urinary nitrogen excretion at the early stage of severe acute pancreatitis. Materials and methods. Prospective, single-center, cohort study. Inclusion criteria: diagnosis of acute pancreatitis and presence of at least one of the predictors of severe course. Among all patients (n = 72), a cohort of patients with severe acute pancreatitis (n = 32) was allocated. Three groups were formed in it: the first one – all patients, the second one – survivors (n = 24), the third one – deceased (n = 8). Urinary nitrogen excretion was determined using the Deacon formula. Measurements were performed on the first, third and fifth days of the disease. Statistical processing of the material was carried out by the SPSS software package. The null hypothesis was rejected at p < 0.05. Results. In the first week of the disease in all groups, the maximum urinary nitrogen excretion occurs on the 3rd day. When comparing the results of the second and third groups, it was found that the urinary nitrogen excretion on the first and fifth days did not have a statistically significant difference between the groups (respectively, p = 0.138, p = 0.572), and the results of the third day have (p = 0.014). A similar pattern remains when recalculating the nitrogen loss in the urine to the ideal weight; for the third day, the differences between the second and third groups were statistically significant (p = 0.007). ROC analysis of urinary nitrogen excretion of the third day calculated to the ideal body weight showed an area under the curve of 0.813 (p < 0.009). The value at the cut-off point is defined as 0.65 g/kg/day. The sensitivity of the model was 0.75%, specificity – 0.83%. Conclusion. If in a patient with acute pancreatitis, there is urinary nitrogen excretion on the third day from the onset of the disease, calculated to an ideal body weight of ≥ 0.65 g/kg/day, an unfavorable outcome of the disease is predicted.

Resting energy expenditure and urinary nitrogen excretion during stress-induced hyperglycemia at an early phase of acute severe pancreatitis

2020 ◽  
Vol 21 (3) ◽  
pp. 83-86
Author(s):  
O. G. Sivkov ◽  
◽  
A. O. Sivkov ◽  
◽  
Keyword(s):  
Acute Pancreatitis ◽  
Energy Expenditure ◽  
Early Phase ◽  
Resting Energy Expenditure ◽  
Nitrogen Excretion ◽  
Acute Severe Pancreatitis ◽  
Severe Pancreatitis ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen ◽  
Resting Energy

Purpose. To investigate the features of resting energy expenditure and urinary nitrogen excretion during stress-induced hyperglycemia at an early phase of acute severe pancreatitis. Materials and methods. The study design was a prospective single-center cohort study. The inclusion criteria were: diagnosed acute pancreatitis and at least one severity predictor. On day one, three, and five the dark blood glycemic index and urinary nitrogen excretion were measured and resting energy expenditure was determined in all patients. From the total number of cases (n = 72), a cohort of patients with severe acute pancreatitis was singled out (n = 23). In that cohort, three groups were formed. The first group included measurements made over the whole observation period (n = 69), the second – normoglycemia (n = 48), and the third one – hyperglycemia. Stress-induced hyperglycemia was determined as increased blood glucose ≥ 11.1 mmol/L. The raw data were statistically processed using SPSS package. The zero hypothesis was rejected at p < 0.05. Results. A statistically significant difference was found between the second and third groups in the glycemia index (p < 0.001) and urinary nitrogen excretion (p = 0.022), but not in the resting energy expenditure (p = 0.157). The prevalence of glycemia among the deceased amounted to 66.6% and among the survived – 17.2%. To make up the quantity of nitrogen lost with urine, the normoglycemia patients required an uptake of 117.1 nonprotein kcal per 1 g of nitrogen, and the hyperglycemia patients -61.7 kcal. Conclusion. At an early phase of acute severe pancreatitis, urinary nitrogen excretion rises in a statistically significant manner in patients with stress-induced hyperglycemia. To make up the urinary nitrogen loss, the normoglycemia patients require 117.1 nonprotein kcal per 1 g of nitrogen while hyperglycemia patients – 61.7.

scholarly journals Feasibility of achieving different protein targets using a hypocaloric high-protein enteral formula in critically ill patients

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Pierre Singer ◽  
Itai Bendavid ◽  
Ilana BenArie ◽  
Liran Stadlander ◽  
Ilya Kagan
Keyword(s):  
Critically Ill ◽  
Nitrogen Balance ◽  
High Protein ◽  
Nitrogen Excretion ◽  
Protein Targets ◽  
Protein Target ◽  
Group A ◽  
Group B ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen

Abstract Background and aims Combining energy and protein targets during the acute phase of critical illness is challenging. Energy should be provided progressively to reach targets while avoiding overfeeding and ensuring sufficient protein provision. This prospective observational study evaluated the feasibility of achieving protein targets guided by 24-h urinary nitrogen excretion while avoiding overfeeding when administering a high protein-to-energy ratio enteral nutrition (EN) formula. Methods Critically ill adult mechanically ventilated patients with an APACHE II score > 15, SOFA > 4 and without gastrointestinal dysfunction received EN with hypocaloric content for 7 days. Protein need was determined by 24-h urinary nitrogen excretion, up to 1.2 g/kg (Group A, N = 10) or up to 1.5 g/kg (Group B, N = 22). Variables assessed included nitrogen intake, excretion, balance; resting energy expenditure (REE); phase angle (PhA); gastrointestinal tolerance of EN. Results Demographic characteristics of groups were similar. Protein target was achieved using urinary nitrogen excretion measurements. Nitrogen balance worsened in Group A but improved in Group B. Daily protein and calorie intake and balance were significantly increased in Group B compared to Group A. REE was correlated to PhA measurements. Gastric tolerance of EN was good. Conclusions Achieving the protein target using urinary nitrogen loss up to 1.5 g/kg/day was feasible in this hypercatabolic population. Reaching a higher protein and calorie target did not induce higher nitrogen excretion and was associated with improved nitrogen balance and a better energy intake without overfeeding. PhA appears to be related to REE and may reflect metabolism level, suggestive of a new phenotype for nutritional status. Trial registration 0795-18-RMC.

Effect of starch on the utilization by sheep of a straw diet supplemented with urea and minerals

1976 ◽  
Vol 27 (1) ◽  
pp. 139 ◽  
Author(s):  
JG Mulholland ◽  
JB Coombe ◽  
WR McManus
Keyword(s):  
Organic Matter ◽  
Nitrogen Retention ◽  
Nitrogen Excretion ◽  
Digestible Organic Matter ◽  
Cellulose Digestibility ◽  
Oat Straw ◽  
Total Body ◽  
Body Energy ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen

Individually penned Border Leicester x Merino wethers, aged 11 months, were fed ad lib. for 16 weeks on a basal ration of ground, pelleted oat straw, urea and minerals, supplemented with 0, 5, 10, 15, 20, 30 or 40% starch. The diets contained equal percentages of nitrogen and minerals. Dry matter intake reached a maximum of 2000 g/day with 30% starch; above this starch level, digestive disturbances were observed. Organic matter digestibility was increased by the addition of starch, but cellulose digestibility was depressed by as much as 18 units with the addition of 30% starch. Up to 10% the starch level had little effect on cellulose digestibility. Liveweight change was significantly correlated with digestible organic matter intake, mean daily weight gains varying from 22 g with no starch to 104 g with 30% starch. However, a large percentage of the liveweight gain was as total body water, and body energy storage increased appreciably only when the diet contained at least 20% starch. The inclusion of 5% starch slightly depressed both intake and liveweight gain. Daily clean wool production was significantly increased at starch levels higher than 20% and ranged from 5.3 to 7.5 g/day with 0 and 40% starch respectively. Increasing levels of starch had little effect on apparent nitrogen digestibility, but resulted in a substantial increase in nitrogen retention through a reduction in urinary nitrogen excretion. Serum urea levels fell from a mean of 42 mg/100 ml during the first week to 31 mg/100 ml during subsequent periods, with no significant differences between diets. With the general exception of potassium, mineral balances were positive or close to zero throughout the experiment.

Branched-Chain Amino Acids, Nitrogen Excretion and Injury in Man

1976 ◽  
Vol 50 (5) ◽  
pp. 393-399 ◽  
Author(s):  
J. H. Wedge ◽  
R. De Campos ◽  
A. Kerr ◽  
R. Smith ◽  
Rose Farrell ◽  
...  
Keyword(s):  
Amino Acids ◽  
Venous Blood ◽  
Branched Chain Amino Acids ◽  
Nitrogen Excretion ◽  
Adult Males ◽  
Blood Concentrations ◽  
Branched Chain ◽  
Injured Patients ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen

1. Venous blood concentrations of the branched-chain amino acids, valine, leucine and isoleucine, and urinary nitrogen excretion have been measured in sixteen adult males, from 2 h to 7 days after injury, and in four adults after elective skin grafts. 2. In the injured group the concentrations of these amino acids rose significantly 24 h after injury and had doubled at 4 days and remained high; in contrast the skin-graft patients showed no significant change. 3. In those injured patients with initial hyperketonaemia, defined as more than 0·2 mmol/l, the increase in concentrations of branched-chain amino acids at the fourth and seventh days after injury was significantly less than in those with normoketonaemia, and was accompanied by lower urinary nitrogen excretion throughout the whole period. 4. It is suggested that the changes in the concentration of branched-chain amino acids after injury indicate decreased uptake by muscle or excessive release due to an imbalance between protein synthesis and protein catabolism in this tissue.

Weight and Menstrual Function in Patients with Eating Disorders and Cystic Fibrosis

PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 522-522
Author(s):  
ALBERT C. HERGENROEDER
Keyword(s):  
Cystic Fibrosis ◽  
Eating Disorders ◽  
Body Weight ◽  
Growth Curves ◽  
Ideal Body Weight ◽  
Menstrual Function ◽  
Ideal Body ◽  
The Ideal

To the Editor.— This letter is in response to the article entitled "Weight and Menstrual Function in Patients with Eating Disorders and Cystic Fibrosis."1 Under "Methods," the authors describe a method for calculating percent ideal body weight by plotting the patient's height on standard growth curves derived from the data of Hamill et al,2 and the ideal body weight being the weight at the same percentile for age. Using the tables of Hamill to calculate percentages of height and weight for females older than 10 years and males older than 11½ years should be done cautiously.

The effect of ERDP:FME ratio and DUP supply from concentrates on the performance of lactating ewes offered grazed grass

1996 ◽  
Vol 1996 ◽  
pp. 160-160
Author(s):  
R.G. Wilkinson ◽  
L.A. Sinclair ◽  
J. Powles ◽  
C.M. Minter
Keyword(s):  
Crude Protein ◽  
Microbial Growth ◽  
High Rate ◽  
Nitrogen Excretion ◽  
Crude Protein Content ◽  
Nitrogen Utilisation ◽  
Metabolisable Energy ◽  
Urinary Nitrogen Excretion ◽  
Urinary Nitrogen ◽  
Degradable Protein

Fresh grass is a highly variable product, which is generally characterised as having a high crude protein content, with a high rate and extent of degradation in the rumen. For lactating ruminants, this may result in an effective rumen degradable protein: fermentable metabolisable energy (ERDP:FME) ratio in excess of the optimum requirement for microbial growth, leading to inefficient nitrogen utilisation and high levels of urinary nitrogen excretion. One method of improving the efficiency of nitrogen utilisation is the use of supplements. An appropriate supplement should optimise ERDP and FME supply to the rumen and provide sufficient metabolisable protein (MP) to balance animal requirements. The objective of the experiment was to investigate the response of lactating ewes offered grazed grass to variations in ERDP:FME ratio and digestible undegradable protein (DUP) supply from concentrate supplements.

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