The effect of different intravenous nutritional regimens on renal regeneration during acute renal failure in the rat

Abstract

Acute renal failure in the surgical patient is accompanied by a state of hypermetabolism and increased catabolism. Nutritional therapy is therefore directed at the preservation of body cell mass and protein synthesis for repair of wounds, repair of the damaged renal tubuli and maintenance of host defense mechanisms. We examined the effect of two levels of protein intake (18.4 ± 1.4 and 30.8 ± 2.4 mg N/100 g BW/day) and three different amino-acid formulations (Freamine III ®, Nephramine ® and a made-up mixture of Nephramine ® ± Freamine ® HBC) on renal regeneration following mercury chloride-induced acute renal failure in the rat. All animals suffered severe renal failure manifested by increased plasma urea and creatinine levels, decreased creatinine clearance and increased fractional excretion of sodium. Incorporation of 3H-thymidine into renal DNA on day 4 of acute renal failure was similar in all six groups studied, irrespective of the amount or composition of amino-acids infused. Renal regeneration during acute renal failure in the rat seems not to be affected either by the quantity or quality of amino-acids infused. However, although not reaching statistical significance, increased amounts of a standard TPN formulation may depress renal regeneration.