Blood urea in preterm infants on routine parenteral nutrition: A multiple linear regression analysis.


Journal

Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603

Informations de publication

Date de publication:
01 2021
Historique:
received: 12 11 2019
revised: 22 04 2020
accepted: 26 04 2020
pubmed: 20 5 2020
medline: 18 8 2021
entrez: 20 5 2020
Statut: ppublish

Résumé

Blood urea is considered a marker of amino acid utilization in preterm infants on routine parenteral nutrition. However, the association between blood urea and intravenous amino acid intake remains debated. To evaluate the association between blood urea and both nutrition and clinical data, in a large cohort of preterm infants. Consecutively admitted preterm infants with a gestational age of less than 32 weeks and a birth weight lower than 1250 g on routine parenteral nutrition from the first hour of life were studied. Clinical and nutrition data collected hourly during the hospitalization were used in multiple linear regression analysis. We studied 674 patients and 1863 blood urea determinations. Blood urea concentration was positively associated with blood creatinine concentration, intravenous amino acid intake, patent ductus arteriosus and respiratory distress syndrome, and negatively associated with intravenous non-protein energy intakes, daily weight change, gestational age, being small for gestational age, antenatal steroids therapy and reverse flow in the umbilical artery (p < 0.001; R = 0.7). From a nutrition perspective, in our large cohort of small preterm infants blood urea was positively correlated with intravenous amino acid intake and negatively correlated with intravenous non-protein energy intake. This is in line with current knowledge in human physiology and suggest that a reduction of intravenous amino acid intake based on blood urea concentrations was justified.

Sections du résumé

BACKGROUND
Blood urea is considered a marker of amino acid utilization in preterm infants on routine parenteral nutrition. However, the association between blood urea and intravenous amino acid intake remains debated.
AIMS
To evaluate the association between blood urea and both nutrition and clinical data, in a large cohort of preterm infants.
METHODS
Consecutively admitted preterm infants with a gestational age of less than 32 weeks and a birth weight lower than 1250 g on routine parenteral nutrition from the first hour of life were studied. Clinical and nutrition data collected hourly during the hospitalization were used in multiple linear regression analysis.
RESULTS
We studied 674 patients and 1863 blood urea determinations. Blood urea concentration was positively associated with blood creatinine concentration, intravenous amino acid intake, patent ductus arteriosus and respiratory distress syndrome, and negatively associated with intravenous non-protein energy intakes, daily weight change, gestational age, being small for gestational age, antenatal steroids therapy and reverse flow in the umbilical artery (p < 0.001; R = 0.7).
CONCLUSIONS
From a nutrition perspective, in our large cohort of small preterm infants blood urea was positively correlated with intravenous amino acid intake and negatively correlated with intravenous non-protein energy intake. This is in line with current knowledge in human physiology and suggest that a reduction of intravenous amino acid intake based on blood urea concentrations was justified.

Identifiants

pubmed: 32423698
pii: S0261-5614(20)30213-2
doi: 10.1016/j.clnu.2020.04.039
pii:
doi:

Substances chimiques

Amino Acids 0
Urea 8W8T17847W
Creatinine AYI8EX34EU

Types de publication

Evaluation Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

153-156

Informations de copyright

Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interest The authors report no conflicts of interest.

Auteurs

Ilaria Giretti (I)

Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - G. M. Lancisi - G. Salesi, Ancona, Italy. Electronic address: i.giretti@pm.univpm.it.

Alessio Correani (A)

Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.

Luca Antognoli (L)

Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - G. M. Lancisi - G. Salesi, Ancona, Italy.

Chiara Monachesi (C)

Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - G. M. Lancisi - G. Salesi, Ancona, Italy.

Paolo Marchionni (P)

Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.

Chiara Biagetti (C)

Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.

Maria Paola Bellagamba (MP)

Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.

Paola Cogo (P)

Department of Medicine, University of Udine, Udine, Italy.

Rita D'Ascenzo (R)

Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.

Ilaria Burattini (I)

Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.

Virgilio P Carnielli (VP)

Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - G. M. Lancisi - G. Salesi, Ancona, Italy; Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.

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