[Parenteral feeding and urea nitrogen balance after binephrectomy. The hemodialysed dog as an experimental model]

In order to realize equalibrated metabolic conditions after bilateral nephrectomy, 6 male mongrel dogs were exclusively fed by parenteral infusions with a dog specific compound of essential amino acids, glutamate and/or hypertonic glucose (0.19 g nitrogen and/or 52-76 kcal per kg and day). Daily dialyses required by infusion volumes up to 1500 ml/day were performed in the anephric, conscious dogs by means of a closed batch haemodialysis system (Rhodial 75 R-Rh¿one-Poulenc-France) and highly permeable membranes (RP 6 R-polyacrylonitrile-Rh¿one-Poulence-France), which allowed a precise ultrafiltration control, improved tolerance to important ultrafiltration volumes and direct dialysate analysis. Comparing the urea nitrogen production in a pre- and post-nephrectomy period with a 4 successive days schedule of only glucose, followed by amino acid administration, a marked net reduction of nitrogen supply: urea nitrogen excretion ratio to one third was demonstrated after nephrectomy, when amino acid infusions were administrated instead of glucose. After a short review of protein synthesis in acute uraemia, the possible relation of the data provided by this study and the evident clinical benefit of parenteral nutrition in acute uraemia was pointed out.