TY - JOUR
T1 - The Efficacy of Nutrition Support in Infected Patients with Chronic Renal Failure
AU - Vehe, Kathryn L.
AU - Brown, Rex O.
AU - Moore, Linda W.
AU - Acchiardo, Sergio R.
AU - Luther, R. Wayne
PY - 1991/1/1
Y1 - 1991/1/1
N2 - Patients with chronic renal failure are at considerable nutritional risk due to restricted diets, poor intake, and dialysis-related protein losses; therefore, they often require specialized nutrition support. It is difficult, however, to gauge the success of the intervention, since the gold standard nitrogen balance cannot be easily employed. We examined the usefulness of three visceral proteins, insulinlike growth factor 1 (IGF-1), fibronectin (FBN), and prealbumin (PA), as markers of nutrition support efficacy in patients with chronic renal failure. Fourteen patients receiving enteral (1) or parenteral (13) nutrition were studied for 7-28 days. The six males and eight females attained intakes of protein and nonprotein energy of 1.3 ± 0.3 (mean ± SD) g/kg/day and 34 ± 6 kcal/kg/day, respectively. Blood samples taken on days 1, 4, 7, 14, 21, and 28 were assayed for IGF-1, FBN, and PA concentrations. Protein levels were correlated with cumulative nonprotein energy and protein intake. Concentrations of IGF-1 at baseline (0.90 ± 0.48 U/ml) rose significantly by day 4 (1.35 ± 0.78 U/ml) and remained significantly above baseline at days 7 (1.44 ± 0.68 U/ml), 14 (1.63 ± 1.05 U/ml), and 28 (1.59 ± 0.98 U/ml). Baseline FBN (113 ± 53 μg/ml) and PA (15.3 ± 7.8 mg/dl) concentrations rose significantly by day 28 (FBN, 163 ± 51 μg/ml; PA, 24.6 ± 19.0 mg/dl). The PA concentrations correlated significantly with cumulative nonprotein calories and cumulative protein intake (r = 0.37, p < 0.01; r = 0.43, p < 0.01, respectively). Both IGF-1 and PA show promise as markers of nutrition support efficacy in this complex patient population.
AB - Patients with chronic renal failure are at considerable nutritional risk due to restricted diets, poor intake, and dialysis-related protein losses; therefore, they often require specialized nutrition support. It is difficult, however, to gauge the success of the intervention, since the gold standard nitrogen balance cannot be easily employed. We examined the usefulness of three visceral proteins, insulinlike growth factor 1 (IGF-1), fibronectin (FBN), and prealbumin (PA), as markers of nutrition support efficacy in patients with chronic renal failure. Fourteen patients receiving enteral (1) or parenteral (13) nutrition were studied for 7-28 days. The six males and eight females attained intakes of protein and nonprotein energy of 1.3 ± 0.3 (mean ± SD) g/kg/day and 34 ± 6 kcal/kg/day, respectively. Blood samples taken on days 1, 4, 7, 14, 21, and 28 were assayed for IGF-1, FBN, and PA concentrations. Protein levels were correlated with cumulative nonprotein energy and protein intake. Concentrations of IGF-1 at baseline (0.90 ± 0.48 U/ml) rose significantly by day 4 (1.35 ± 0.78 U/ml) and remained significantly above baseline at days 7 (1.44 ± 0.68 U/ml), 14 (1.63 ± 1.05 U/ml), and 28 (1.59 ± 0.98 U/ml). Baseline FBN (113 ± 53 μg/ml) and PA (15.3 ± 7.8 mg/dl) concentrations rose significantly by day 28 (FBN, 163 ± 51 μg/ml; PA, 24.6 ± 19.0 mg/dl). The PA concentrations correlated significantly with cumulative nonprotein calories and cumulative protein intake (r = 0.37, p < 0.01; r = 0.43, p < 0.01, respectively). Both IGF-1 and PA show promise as markers of nutrition support efficacy in this complex patient population.
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U2 - 10.1002/j.1875-9114.1991.tb04292.x
DO - 10.1002/j.1875-9114.1991.tb04292.x
M3 - Article
C2 - 1923911
AN - SCOPUS:0026015058
SN - 0277-0008
VL - 11
SP - 303
EP - 307
JO - Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
JF - Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
IS - 4
ER -