+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Determination of protein catabolic rate in patients on chronic intermittent hemodialysis: urea output measurements compared with dietary protein intake and with calculation of urea generation rate



Determination of protein catabolic rate in patients on chronic intermittent hemodialysis: urea output measurements compared with dietary protein intake and with calculation of urea generation rate



American Journal of Kidney Diseases 25(6): 887-895



We assessed the agreement between different methods of determining protein catabolic rate (PCR) in hemodialysis patients and the possible influence of postdialysis urea rebound and the length of the interdialytic interval on the PCR determination. Protein catabolic rate derived from measured total urea output was compared with recorded daily protein intake (DPI) and calculated urea generation rate (G), calculated by the interdialytic increase in serum urea and an estimated urea distribution volume using either the Watson equation or 58% of postdialysis body weight, and by single-pool urea kinetic modelling. In 16 patients PCR derived from calculated G by fixed urea distribution volume showed a significant decrease with blood samples obtained 10 minutes after dialysis onward as compared with immediately after dialysis, leading to an approximately 6% decrease at 60 minutes. Protein catabolic rate values derived from blood samples taken 15 to 60 minutes after dialysis were not significantly different. Urea kinetic modelling led to a significant increase in calculated PCR with samples from 5 minutes after dialysis onward and a total increase by 11.5% at 60 minutes. Different methods for determining PCR were compared in 13 clinically stable outpatients treated with conventional hemodialysis on cellulose acetate membrane dialyzers during 1 week. The mean PCR calculated from measured total urea output was 61.3 g/24 hr (range, 43.7 to 83.2 g/24 hr). Assessment of DPI as compared with PCR calculated from measured total urea output was lower by 7.5% (95% confidence intervale [CI], 1.4 to 17.5).

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 042777162

Download citation: RISBibTeXText

PMID: 7771485

DOI: 10.1016/0272-6386(95)90571-5


Related references

Simplified calculation of urea volume v generation rate g and normalized protein catabolic rate npcr in hemodialysis. Journal of the American Society of Nephrology 3(3): 353, 1992

Fluctuations of urea generation rate following protein intake in hemodialysis patients measured using urea. Journal of the American Society of Nephrology 6(3): 581, 1995

Protein catabolic rate pcr in chronic hemodialysis validation of methods using estimations of urea generation. Journal of the American Society of Nephrology 3(3): 396, 1992

Higher KT/V urea associated with greater protein catabolic rate and dietary protein intake in children treated with CCPD compared to CAPD. Mid-European Pediatric CPD Study Group (MPCS). Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis 10: 310-314, 1994

Relationship between protein catabolic rate and kt v urea in chronic hemodialysis patients. Blood Purification 9(1): 43, 1991

Equations for the calculation of the protein catabolic rate from predialysis and postdialysis urea concentrations and residual renal clearance in stable hemodialysis patients. Blood Purification 15(3): 157-168, 1997

Analysis of the urea generation rate and the protein catabolic rate in hemodialyzed patients. Artificial Organs. : 832-836, 1995

Protein catabolic rate may underestimate dietary protein intake in hemodialysis patients. Nephron 82(2): 97-99, 1999

Post-hemodialysis urea rebound and cardiopulmonary recirculation in high-flux hemodialysis Relation to protein catabolic rate. Journal of the American Society of Nephrology 5(3): 508, 1994

Urea rebound and residual renal function in the calculation of Kt/V and protein catabolic rate. Kidney International. Suppl. 41: S278-S281, 1993

Longitudinal Associations among Renal Urea Clearance-Corrected Normalized Protein Catabolic Rate, Serum Albumin, and Mortality in Patients on Hemodialysis. Clinical Journal of the American Society of Nephrology 12(7): 1109-1117, 2017

Equations for direct calculation of protein catabolic rate from a single measurement of dialyzed urea in patients dialyzed twice weekly. Nephrology Dialysis Transplantation 12(9): A134, 1997

Equations for normalized protein catabolic rate based on two-point modeling of hemodialysis urea kinetics. Journal of the American Society of Nephrology 7(5): 780-785, 1996

Protein catabolic rate determination from a single measurement of dialyzed urea. Asaio Journal 41(3): M804-M809, 1995

Low protein intake as assessed by normalized protein catabolic rate or dietary protein intake predisposes to the development of soft tissue calcifications in pediatric end-stage renal disease patients on maintenance dialysis. Pediatric Research 51(4 Part 2): 434A, 2002