Effect of route of nutrition on recovery of hepatic organic anion clearance after fasting

Bradford Waters, R. Kudsk, E. J. Jarvi

Research output: Contribution to journalArticle

Abstract

Background: Previous work documented a 40% depression of hepatic indocyanine green (ICG) clearance (CIICG) in pigs fasted to 20% weight loss, with return to normal within 12 days of food refeeding. ClICG in pigs is insensitive to changes in hepatic blood flow but very sensitive to changes in hepatic function (HF). Serial ClrCG determinations were performed to quantify the effect of route of nutrient delivery on recovery of HF. Methods: Fourteen pigs were fasted to 20% weight loss (12.8 days average) with both gastrostomy and intravenous catheters placed in each animal midway through the fast. ClrCG was measured before fast, after fast, and after 12 days refeeding through the enteral or parenteral route at 125 kcal/kg/day with isonitrogenous, isocaloric diets containing 9% fat. Urine and stool were analyzed for total nitrogen. Results: No significant differences appeared between groups in nitrogen output during fasting (4.5 ± 1.2 gm/kg enteral, 4.6 ± 1.2 gm/kg parenteral), in nitrogen intake (800 ± 19 mg/kg/day enteral, 810 � 10 mg/kg/day parenteral), or in before or after fast ClrCG� but enteral feeding produced more positive nitrogen balance. ClICG improved significantly with enteral but not with parenteral feeding. Conclusions: Enteral feeding produces faster nitrogen accrual and reverses the depression of major pathways of bilirubin and organic anion excretion associated with malnutrition. Parenteral feeding failed to improve organic anion clearance despite weight gain.

Original languageEnglish (US)
Number of pages1
JournalNutrition in Clinical Practice
Volume9
Issue number6
DOIs
StatePublished - Jan 1 1994

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Anions
Fasting
Nitrogen
Small Intestine
Liver
Swine
Parenteral Nutrition
Enteral Nutrition
Weight Loss
Food
Indocyanine Green
Gastrostomy
Recovery of Function
Bilirubin
Malnutrition
Weight Gain
Catheters
Fats
Urine
Diet

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Effect of route of nutrition on recovery of hepatic organic anion clearance after fasting. / Waters, Bradford; Kudsk, R.; Jarvi, E. J.

In: Nutrition in Clinical Practice, Vol. 9, No. 6, 01.01.1994.

Research output: Contribution to journalArticle

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abstract = "Background: Previous work documented a 40{\%} depression of hepatic indocyanine green (ICG) clearance (CIICG) in pigs fasted to 20{\%} weight loss, with return to normal within 12 days of food refeeding. ClICG in pigs is insensitive to changes in hepatic blood flow but very sensitive to changes in hepatic function (HF). Serial ClrCG determinations were performed to quantify the effect of route of nutrient delivery on recovery of HF. Methods: Fourteen pigs were fasted to 20{\%} weight loss (12.8 days average) with both gastrostomy and intravenous catheters placed in each animal midway through the fast. ClrCG was measured before fast, after fast, and after 12 days refeeding through the enteral or parenteral route at 125 kcal/kg/day with isonitrogenous, isocaloric diets containing 9{\%} fat. Urine and stool were analyzed for total nitrogen. Results: No significant differences appeared between groups in nitrogen output during fasting (4.5 ± 1.2 gm/kg enteral, 4.6 ± 1.2 gm/kg parenteral), in nitrogen intake (800 ± 19 mg/kg/day enteral, 810 � 10 mg/kg/day parenteral), or in before or after fast ClrCG� but enteral feeding produced more positive nitrogen balance. ClICG improved significantly with enteral but not with parenteral feeding. Conclusions: Enteral feeding produces faster nitrogen accrual and reverses the depression of major pathways of bilirubin and organic anion excretion associated with malnutrition. Parenteral feeding failed to improve organic anion clearance despite weight gain.",
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