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Perit Dial Int 16(4): 347-351 1996
© 1996 International Society for Peritoneal Dialysis
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Peritoneal Dialysis International, Vol 16, Issue 4, 347-351
Copyright © 1996 by International Society for Peritoneal Dialysis

Articles

The rationale and ultimate limitations of urea kinetic modelling in the estimation of nutritional status

JM Bargman

Department of Medicine, University of Toronto, Ontario, Canada.

OBJECTIVE: This paper reviews protein flux and amino acid metabolism and the potential inaccuracies inherent in using urea kinetics as an estimate of these processes, particularly in the patient undergoing peritoneal dialysis. The problems of extrapolating these estimates back to the whole patient are examined, addressing assumptions about neutral nitrogen balance, and the difficult issue of normalizing urea-derived indices to body size. CONCLUSIONS: Urea kinetics can be a helpful tool for assessing nutritional indices, but there are many caveats and many pitfalls that must be kept in mind to avoid being lulled into a false sense of confidence by the comfort of numbers.






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