Abstract

Normalized protein catabolic rate (nPCR) calculation depends on estimating the urea generation between consecutive hemodialysis (HD) treatments. Two-point nPCR using blood urea nitrogen (BUN) before and after the same HD treatment has not been validated in pediatric patients, who typically receive a more intense HD dose than adults. This study aimed to compare nPCR calculated with a two-point vs. a three-point nPCR model in pediatric HD patients.Pediatric patients receiving HD at 2 units were enrolled. Three BUN measurements were obtained around a midweek HD treatment: one prior to HD (preBUN1), one 30 s after HD (30sBUN), and one prior to the subsequent HD (preBUN2). The two-point nPCR model was calculated using preBUN1 and 30sBUN and the three-point nPCR model was calculated using preBUN2 and 30sBUN.Seventy-six BUN sets from 35 patients were analyzed. Mean age was 16.4?±?3.5 years. Mean dry weight was 51.4?±?17.1 kg. Mean spKt/V was 1.54?±?0.23. Mean preBUN2 was significantly lower than mean preBUN1 (60.2?±?18.6 vs. 64.0?±?18.9 mg/dl, p?=?0.0001). nPCR obtained from the three-point model was significantly lower than nPCR obtained from the two-point model (1.07?±?0.31 vs. 1.17?±?0.31 g/kg/day, p?=?0.00001). Seven of 76 (9.2 %) paired comparisons yielded three-point nPCR <1 vs. two-point nPCR >1.Our data show that in pediatric patients receiving HD, the ((1) two-point and three-point models lead to significantly different nPCRs, and (2) inaccurate protein intake assessment may result from reliance on a two-point model for nPCR estimates.

View details for DOI 10.1007/s00467-012-2371-x

View details for Web of Science ID 000316571400014

View details for PubMedID 23212562