Uric acid: Effects on serum and urine levels in patients receiving intravenous dextrose, fat, and/or amino acid solutions

Abstract

Parenteral dextrose/amino acid solutions reduce serum uric acid levels when infused into patients. To elucidate the mechanism further, 53 patients with invasive bladder cancer were selected for study. Patients received either amino acids alone ( n = 13), 5% dextrose + amino acids ( n = 15), 5% dextrose in water ( n = 13), 25% dextrose + amino acids ( n = 7), or fat 10% + amino acids ( n = 5). All patients received 2500 ml intravenously for 3 days preop and 3000 ml for at least 7 days postop containing 1.4 g AA/kg/day; after Day +7 oral intake was allowed. No patient had gout. Serial serum uric acid levels and daily 24-hr urine uric acid and creatinine levels were measured. There were no significant differences among intravenous groups in: mean patient age, percentage ideal body weight, duration of operation, operative blood loss, fluid-blood replacement, or serum and urine creatinine levels. Mean serum uric acid levels decreased postoperatively in all groups. The mean change in serum uric acid levels from Day −3 to Day +7 was significantly different between the D5/AA group (2.3 ± 0.2 mg/dl) and the AA/H 2O group (1.1 ± 0.4 mg/dl) and between the D25/AA group (2.8 ± 0.6 mg/dl) and the AA/H 2O and D5W (1.4 ± 0.3 mg/dl) group. This significant change in mean serum uric acid levels with infusion of 5 and 25% dextrose with amino acids occurred without increased uricosuria compared to the other groups of patients.