Endogenous nitrogen excretion in alcoholic patients on an enteral diet

1. Obligatory nitrogen losses were evaluated in a group of 9 chronic alcoholic adult males of low socioeconomic status, with an intake of approximately 1 liter/day of a Brazilian beverage (45% ethanol by weight) for at least 5 years. 2. The patients were fed a nitrogen-free diet orally or by tube for 7 days. Since endogenous nitrogen excretion was statistically similar for all subjects, the data were pooled for overall analysis. 3. A stable rate of urinary nitrogen output of 28.42 +/- 11.93 mg N kg-1 day-1 was reached in about 3 days both after oral and tube feeding. The obligatory fecal losses for days 4 to 7 were 17.20 +/- 8.86 mg N kg-1 day-1. 4. Based on the factorial approach, considering the skin and other minor nitrogen losses to be 10 mg N kg-1 day-1, the total endogenous obligatory nitrogen loss for this group of alcoholic patients was 55.62 +/- 18.57 mg N kg-1 day-1. 5. The present results are discussed on the basis of the controversy about the nitrogen requirement of alcoholic patients. The endogenous nitrogen excretion demonstrated does not suggest the need for increased nitrogen intake, but the protein malnutrition of the patients points to the need for more protein.