Blood urea in preterm infants on routine parenteral nutrition: A multiple linear regression analysis. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Giretti, Ilaria; Correani, Alessio; Antognoli, Luca; Monachesi, Chiara; Marchionni, Paolo; Biagetti, Chiara; Bellagamba, Maria Paola; Cogo, Paola; D'Ascenzo, Rita; Burattini, Ilaria; Carnielli, Virgilio P.
• Is Part Of: Clinical nutrition. Volume 40:Issue 1(2021)
• Page Start: 153
• Page End: 156
• Publication Date: 2021-01
• Subjects: Amino acid -- Blood urea -- Parenteral nutrition -- Preterm infants; AA amino acid -- BUrea blood urea -- BW birth weight -- DOL day of life -- GA gestational age -- IV intravenous -- IVH intraventricular hemorrhage -- NEC necrotizing enterocolitis -- NPE non-protein energy -- PDA patent ductus arteriosus -- PN parenteral nutrition -- RDS respiratory distress syndrome -- SDS standard deviation score -- SGA small for gestational age; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2020.04.039
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: 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.