Catabolic response and parenteral nutrition after simultaneous kidney-pancreas transplantation
Braga, M.; Castoldi, R.; Cristallo, M.; Valeri, R.; Pozza, G.; Di Carlo, V.
Nutrition 8(4): 232-236
1992
ISSN/ISBN: 0899-9007 PMID: 1498454 Document Number: 398475
The catabolism rate induced by simultaneous kidney-pancreas transplantation was studied and the impact of parenteral nutrition (PN) on recovery of graft function was evaluated in 26 diabetic uraemic patients. The average urea nitrogen production (UNP) was 5.2+or-1.7 g during the first 24 h after transplantation, while patients did not receive energy and N support. Energy (30 kcal/kg daily) and N (0.15 g/kg daily) intake started 24 h after surgery. In 14 patients, a mixed regimen was adopted (70% carbohydrates, 30% lipids), and 12 patients received only hypertonic glucose solutions. The recovery of kidney function was immediate in all cases, with a prompt decrease in blood urea N and serum creatinine levels. C-peptide values increased immediately after the revascularization of the pancreas graft and remained within the normal range during the PN period. No significant difference was observed in UNP or glucose tolerance between the mixed-regimen and glucose groups. However, on average, 6.6 and 1.5 hyperglycaemic episodes occurred during the 1st week of PN in the glucose and mixed-regimen groups, respectively. The post-transplantation catabolism rate was similar to that induced by an elective major surgical procedure. Normo-energetic PN did not affect the recovery of kidney and pancreas graft function. A mixed energy regimen seems to be most suitable for kidney-pancreas transplant patients because it prevents hyperglycaemia which might be misdiagnosed as rejection.