Parenteral Nutrition of Renal Disease

Abstract

The rationale for dietary therapy in renal failure has been investigated largely in adults in chronic renal failure. Their nutritional needs have been established primarily on the basis of oral dietary intake and prolonged balance studies. The requirements for maintaining positive nitrogen balance in adults with chronic renal disease were substantiated largely through the work of Rose and Dekker (1956), Giordanno (1963), and Giovanetti and Maggiore 1964). This has led to the concept of supplying nitrogen of “high biologic activity”, largely in the form of L-essential amino acids. Nitrogen from urea, which is plentiful in uremia, is then synthesized into non-essential amino acids and, with essential amino acids, into protein, the result being the maintenance of positive nitrogen balance on the 0.5 gm per kg per day of protein supplied.