Estimation of fecal nitrogen in patients with liver disease

The use of a fecal nitrogen (FN) predictive equation (Am J Clin Nutr 1978; 31:12-22, Cheng) based on dietary nitrogen intake (Nin) [FN (mg/kg/day) = 10.817 + 0.03 Nin(mg/kg/day)] was evaluated in patients with liver disease with and without concomitant lactulose therapy. Ten male cirrhotics were studied in 27 3-day nitrogen balance studies including measured daily total urinary nitrogen, total FN, and Nin calculated from weighted food records. The Cheng formula accurately predicted FN in cirrhotics not receiving lactulose who demonstrated normal digestion and absorption of dietary protein. However, the formula did not accurately reflect FN excretion in patients receiving lactulose who showed impaired protein digestibility and significantly increased fecal weight. The Cheng predictive equation is a useful index of FN excretion in patients with liver disease whose digestive and absorptive capacities are not compromised by exogenous factors.