[The characteristics of parenteral feeding in patients with kidney failure]

The peculiarities of parenteral nutrition (PN) in patients with renal insufficiency are related first and foremost to the nature of acute renal failure (ARF). The classification of the latter employed shows that it is a matter of a secondary condition, readily responsive to a number of risk factors. To make the diagnosis numerous laboratory examinations, indicators and tests, and the correlations between them are evaluated. Apart from characterizing the kidney function, they make part of the modern basis underlying the differential diagnosis and therapeutic approach. The author's views and experience had with PN in ARF patients undergoing urological surgery are outlined. The basic nutritional problem faced is linked to the patients nitrogen balance and protein food. Protein metabolism and the loss of proteins in the course of dialysis lend themselves to inhibition and compensation by infusions of amino acids and L-histidine at daily dose 0.2-0.6 g/kg body mass. The amino acid mixtures obtained on the KE principle (potato-egg protein) are preferable since they are readily transformed and contain antiammonemic semi-essential amino acids. During chronic dialysis, the need of amino acids augments to 0.8-1.5 g/kg daily. Water intake is limited within the frames of diuresis and perspiration. Calorie requirements vary in the range 25-40 kcal/kg average, and are met by nonprotein calories.