NITROGEN METABOLISM IN CHRONIC RENAL FAILURE:—Nitrogen Balance and 15N Tracing Study with 15N-urea Administration—

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Nitrogen balance and m15N incorporation into plasma protein and m15N excretion into urine by intravenous administration of 1 gm Nm15-urea were studied over 1 to 2 weeks on 7 non-dialysed patients with chronic renal failure and 7 dialysed patients. Four of the 7 non-dialysed patients were taking low protein diet (Group A) and 3 on low protein diet with addition of essential amino acids (Group B). Of the 7 dialysed patients, 2 were on single pass system (Group C), 2 on 30L dialysate supply system with adsorbents (Group D), and 3 on 10L dialysate supply system with adsorbents (Group E) Nitrogen balance of Group A was remarkably negative, -1.71gm/day and Group B, slightly positive, +0.27gm/day. All dialysed patients of Group C, D, and E showed slightly positive balance, +0.51, +0.63, and +0, 30 respectively, The mean of the highest values of the m15N incorporation into plasma protein in Group A was 0.017 atom % excess, whereas a normal adult on normal diet showed no 15N incorporation at all. The values for patients Group C, D, and E were positive of 0.012, 0.025, and 0.014 atom % excess respectively. The results indicate that reutilization of urea nitrogen into protein synthesis is increased not only in non-dialysed patients with chronic renal failure taking low protein diet but also in dialysed patients taking high protein diet.
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