Renal phosphorus regulation in thermally-injured and multiple trauma patients receiving enterai nutrition JM gervasio

R. O. Brown, J. Sherman, William Hickerson, K. A. Kudsk, Roland Dickerson

Research output: Contribution to journalArticle

Abstract

Profound hypophosphatemia is a common complication in thermally injured (TI) patients of which the etiology is unclear. To investigate renal phosphorus regulation, 20 adult TI patients (> 20% BSA) and 20 multiple trauma (MT) patients requiring tube feedings (TF) were prospectively evaluated. Patients with renal impairment (serum creatinine > 1.6 mg/dl), alkalemia (pH > 7.50), or diabetes mellitus were excluded. Serum phosphorus concentrations (mg/dl; P) were collected at days 1, 3, 7, and 14 after initiation of TF. TF were begun within 1-3 days post injury. Management of hypophosphatemia was shared by the nutrition support and respective primary services. A 24 hr urine was collected during week 1 and 2 for urinary phosphorus excretion (UP; mg/d) and phosphate clearance (UCL; Lid). Data are given as mean ±SD. Average daily phosphate intake during the 14 day study for TI and MT trauma patients was 0.72 ±0.32 mmol/kg/d (34 ±30% as IV) and 0.32 ±0.18 mmol/kg/d (20 ±17% as IV), respectively, p < 0.001. Group P-l P-3 P-7 P-14 TI 2.6 ±0.9 1.9 ±0.82.7 ±1.23.9 ±0.6 MT 2.5 ±0.7 3.0 ±0.8 3.3 ±0.6 3.7 ±0.6p < O.OSbetween groups Group UP-1 UP-2 UCL-1 UCL-2 TI 292±256 377 ±286 11.8± 11.9 14.3 ±12.1 MT 189 ±178 272 ±186 8.5 ±8.9 8.4 ±5.7 Despite a significantly greater intake of phosphorus, TI patients had lower serum P levels on days 3 and 7. TI patients had greater urinary phosphate excretion and clearance compared to MT patients (p = M.S.). TI patients had a 40% to 55% increase in urinary excretion of phosphorus despite an intake that was 125% more than MT patients. Renal phosphorus regulation is only partially responsible for the profound hypophosphatemia observed in thermally injured patients.

Original languageEnglish (US)
JournalJournal of Parenteral and Enteral Nutrition
Volume22
Issue number1
StatePublished - 1998

Fingerprint

Multiple Trauma
Phosphorus
kidneys
nutrition
Kidney
phosphorus
Hypophosphatemia
tube feeding
Enteral Nutrition
excretion
Phosphates
phosphates
Serum
lids
Wounds and Injuries
diabetes mellitus
creatinine
etiology
Creatinine
Diabetes Mellitus

All Science Journal Classification (ASJC) codes

  • Food Science
  • Medicine (miscellaneous)

Cite this

@article{73b31777d6034a3fa91538135025767e,
title = "Renal phosphorus regulation in thermally-injured and multiple trauma patients receiving enterai nutrition JM gervasio",
abstract = "Profound hypophosphatemia is a common complication in thermally injured (TI) patients of which the etiology is unclear. To investigate renal phosphorus regulation, 20 adult TI patients (> 20{\%} BSA) and 20 multiple trauma (MT) patients requiring tube feedings (TF) were prospectively evaluated. Patients with renal impairment (serum creatinine > 1.6 mg/dl), alkalemia (pH > 7.50), or diabetes mellitus were excluded. Serum phosphorus concentrations (mg/dl; P) were collected at days 1, 3, 7, and 14 after initiation of TF. TF were begun within 1-3 days post injury. Management of hypophosphatemia was shared by the nutrition support and respective primary services. A 24 hr urine was collected during week 1 and 2 for urinary phosphorus excretion (UP; mg/d) and phosphate clearance (UCL; Lid). Data are given as mean ±SD. Average daily phosphate intake during the 14 day study for TI and MT trauma patients was 0.72 ±0.32 mmol/kg/d (34 ±30{\%} as IV) and 0.32 ±0.18 mmol/kg/d (20 ±17{\%} as IV), respectively, p < 0.001. Group P-l P-3 P-7 P-14 TI 2.6 ±0.9 1.9 ±0.82.7 ±1.23.9 ±0.6 MT 2.5 ±0.7 3.0 ±0.8 3.3 ±0.6 3.7 ±0.6p < O.OSbetween groups Group UP-1 UP-2 UCL-1 UCL-2 TI 292±256 377 ±286 11.8± 11.9 14.3 ±12.1 MT 189 ±178 272 ±186 8.5 ±8.9 8.4 ±5.7 Despite a significantly greater intake of phosphorus, TI patients had lower serum P levels on days 3 and 7. TI patients had greater urinary phosphate excretion and clearance compared to MT patients (p = M.S.). TI patients had a 40{\%} to 55{\%} increase in urinary excretion of phosphorus despite an intake that was 125{\%} more than MT patients. Renal phosphorus regulation is only partially responsible for the profound hypophosphatemia observed in thermally injured patients.",
author = "Brown, {R. O.} and J. Sherman and William Hickerson and Kudsk, {K. A.} and Roland Dickerson",
year = "1998",
language = "English (US)",
volume = "22",
journal = "Journal of Parenteral and Enteral Nutrition",
issn = "0148-6071",
publisher = "SAGE Publications Inc.",
number = "1",

}

TY - JOUR

T1 - Renal phosphorus regulation in thermally-injured and multiple trauma patients receiving enterai nutrition JM gervasio

AU - Brown, R. O.

AU - Sherman, J.

AU - Hickerson, William

AU - Kudsk, K. A.

AU - Dickerson, Roland

PY - 1998

Y1 - 1998

N2 - Profound hypophosphatemia is a common complication in thermally injured (TI) patients of which the etiology is unclear. To investigate renal phosphorus regulation, 20 adult TI patients (> 20% BSA) and 20 multiple trauma (MT) patients requiring tube feedings (TF) were prospectively evaluated. Patients with renal impairment (serum creatinine > 1.6 mg/dl), alkalemia (pH > 7.50), or diabetes mellitus were excluded. Serum phosphorus concentrations (mg/dl; P) were collected at days 1, 3, 7, and 14 after initiation of TF. TF were begun within 1-3 days post injury. Management of hypophosphatemia was shared by the nutrition support and respective primary services. A 24 hr urine was collected during week 1 and 2 for urinary phosphorus excretion (UP; mg/d) and phosphate clearance (UCL; Lid). Data are given as mean ±SD. Average daily phosphate intake during the 14 day study for TI and MT trauma patients was 0.72 ±0.32 mmol/kg/d (34 ±30% as IV) and 0.32 ±0.18 mmol/kg/d (20 ±17% as IV), respectively, p < 0.001. Group P-l P-3 P-7 P-14 TI 2.6 ±0.9 1.9 ±0.82.7 ±1.23.9 ±0.6 MT 2.5 ±0.7 3.0 ±0.8 3.3 ±0.6 3.7 ±0.6p < O.OSbetween groups Group UP-1 UP-2 UCL-1 UCL-2 TI 292±256 377 ±286 11.8± 11.9 14.3 ±12.1 MT 189 ±178 272 ±186 8.5 ±8.9 8.4 ±5.7 Despite a significantly greater intake of phosphorus, TI patients had lower serum P levels on days 3 and 7. TI patients had greater urinary phosphate excretion and clearance compared to MT patients (p = M.S.). TI patients had a 40% to 55% increase in urinary excretion of phosphorus despite an intake that was 125% more than MT patients. Renal phosphorus regulation is only partially responsible for the profound hypophosphatemia observed in thermally injured patients.

AB - Profound hypophosphatemia is a common complication in thermally injured (TI) patients of which the etiology is unclear. To investigate renal phosphorus regulation, 20 adult TI patients (> 20% BSA) and 20 multiple trauma (MT) patients requiring tube feedings (TF) were prospectively evaluated. Patients with renal impairment (serum creatinine > 1.6 mg/dl), alkalemia (pH > 7.50), or diabetes mellitus were excluded. Serum phosphorus concentrations (mg/dl; P) were collected at days 1, 3, 7, and 14 after initiation of TF. TF were begun within 1-3 days post injury. Management of hypophosphatemia was shared by the nutrition support and respective primary services. A 24 hr urine was collected during week 1 and 2 for urinary phosphorus excretion (UP; mg/d) and phosphate clearance (UCL; Lid). Data are given as mean ±SD. Average daily phosphate intake during the 14 day study for TI and MT trauma patients was 0.72 ±0.32 mmol/kg/d (34 ±30% as IV) and 0.32 ±0.18 mmol/kg/d (20 ±17% as IV), respectively, p < 0.001. Group P-l P-3 P-7 P-14 TI 2.6 ±0.9 1.9 ±0.82.7 ±1.23.9 ±0.6 MT 2.5 ±0.7 3.0 ±0.8 3.3 ±0.6 3.7 ±0.6p < O.OSbetween groups Group UP-1 UP-2 UCL-1 UCL-2 TI 292±256 377 ±286 11.8± 11.9 14.3 ±12.1 MT 189 ±178 272 ±186 8.5 ±8.9 8.4 ±5.7 Despite a significantly greater intake of phosphorus, TI patients had lower serum P levels on days 3 and 7. TI patients had greater urinary phosphate excretion and clearance compared to MT patients (p = M.S.). TI patients had a 40% to 55% increase in urinary excretion of phosphorus despite an intake that was 125% more than MT patients. Renal phosphorus regulation is only partially responsible for the profound hypophosphatemia observed in thermally injured patients.

UR - http://www.scopus.com/inward/record.url?scp=33748267914&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748267914&partnerID=8YFLogxK

M3 - Article

VL - 22

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

SN - 0148-6071

IS - 1

ER -