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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metabolic studies were performed on 19 patients with acute renal failure. Therapy included intravenous hyperalimentation using 15 to 20 g of essential amino acids or 20 to 40 g of essential plus nonessential amino acids and hypertonic glucose (37 to 50%). The effect of this parenteral feeding appears to be primarily pharmacological. Hypertonic glucose promotes the hyperinsulinemia important to be membrane function, the operation of the sodium pump, and cell metabolism. Administration of high biological value crystalline amino acdis potentiates the effect of insulin by inhibiting protein breakdown and promoting protein synthesis, particularly in muscle. This reduces tissue catabolism and urea formation, and promotes potassium, magnesium, and phosphate homeostasis. The branched-chain ketogenic amino acids valine, leucine, and isoleucine may be of particular importance. When indicated, administration of renal failure hyperalimentation and peritoneal or hemodialysis can be expected to complement each other and accelerate recovery. This intravenous fluid therapy, in turn, must be coordinated with proper hemodynamics, usually requiring a colloidal solution to maintain intravascular volume, and cardiotrophic agents such as digitalis and dopamine. Early use of renal failure can be expected to demonstrate the most striking response in terms of survival, early recovery from acute renal failure, and the preservation of physiological homeostasis.
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PMID:Criteria for choosing amino acid therapy in acute renal failure. 10 Oct 72

Clinical characteristics of 46 cases of acute pancreatitis treated with total parenteral nutrition were examined. Hyperalimentation may be used in these severely ill patients with minimal technical or metabolic morbidity. This method of nutritional support can maintain patients with nonfunctional gastrointestinal tracts for several months. Catheter-related sepsis was more common than expected early in the course of acute pancreatitis but caused minimal morbidity. The incidence of catheter-related sepsis late in disease was minor. Hyperalimentation had little if any effect on the pathophysiology of acute pancreatitis as judged by the overall mortality and the incidence and severity of the complications of acute respiratory failure and acute renal failure. It is not clear that parenteral hyperalimentation alters the course of acute pancreatitis but it is a useful adjunct for nutritional support in this illness.
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PMID:Parenteral nutrition in the treatment of acute pancreatitis: effect on complications and mortality. 41 29

The course of 76 consecutive patients with acute renal failure and severe intra-abdominal infection was reviewed to identify the microorganisms responsible, the factor precipitating reoperation, and prognostic indicators. Peritonitis occurred in 75 patients, 48 of whom had abscesses. Twenty-four patients (32%) survived. Anaerobes and fungi were commonly grown from blood. Gram-negative aerobic blood isolates were associated with the highest mortality. Leukocytosis, physical findings, and fever were factors that prompted reexploration whereas diagnostic procedures played an ancillary role. The finding of specifically correctable conditions at reoperation improved survival (P less than .05). Myocardial infarction and disseminated intravascular coagulation affected survival unfavorably whereas hyperalimentation had a favorable influence (P less than .05). Aggressive medical, nutritional, and surgical management results in improved survival rates in these patients.
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PMID:Intra-abdominal infection and acute renal failure. 63 17

Candida sepsis has become one of the most common and dangerous forms of hospital acquired infection. The recommended drug for parenteral treatment of Candida sepsis is amphotericin B, however, its toxic effects preclude its usage in many patients, particularly in the presence of renal failure. A less toxic antifungal agent is 5-fluorocytosine. A patient with Candida albicans sepsis was treated successfully with 5-fluorocytosine by intravenous administration. The fungal infection developed during the course of acute renal failure, repeated surgical intervention, intravenous hyperalimentation, gastrointestinal bleeding and five months of antibiotic therapy. The clinical symptoms receded rapidly and cultures became sterile after one week of intravenous treatment. The predisposing factors, difficulties in prevention and diagnosis of fungal infection are discussed.
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PMID:Candida sepsis successfully treated by parenteral administration of 5-fluorocytosine. 96 77

Acute renal failure (ARF) is characterised by progressive azotaemia, and for therapeutic purposes consideration of prerenal, intrinsic renal and postrenal types still holds good. Prerenal azotaemia is generally caused by loss of body fluids or blood, whereas postrenal azotaemia is effected by acute or chronic urinary tract obstruction. Provided these conditions are recognised on time and treated, they are reversible. However, delay in recognition or treatment could result in renal parenchymal damage and sustained ARF. Therefore utmost attention should be focused on identifying reversible factor(s) in the setting of ARF. Once reversible factors have been excluded, and ARF becomes sustained, a diagnosis of acute intrinsic renal failure is almost certain. Lack of natriuretic and diuretic responses to fluid challenge or infusion of furosemide (frusemide) and dopamine are further indications of this possibility. Management of acute intrinsic renal failure essentially consists of dietary control and dialysis therapy. The latter facilitates fluid and electrolyte management, but does not reduce the overall mortality. The potential benefit of parenteral hyperalimentation to promote renal function recovery must be carefully weighed against the risk of severe infectious complications.
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PMID:Treatment considerations in acute renal failure. 128 Oct 72

Despite intensive efforts in the nutritional treatment of hypercatabolic acute renal failure (ARF), its prognosis is still deleterious. The most important factor determining the outcome of ARF is the extent of catabolism which is caused by alterations of the hormonal milieu, enhanced proteolytic activity, the hemodialysis process and the patient's underlying or superimposed illness like surgical or nonsurgical trauma, rhabdomyolysis and septicemia. Up to now, in randomly assigned studies, hyperalimentation with protein- and nonprotein-derived calories has failed significantly to improve the nutritional status of the patient, although maximal doses of amino acids have been administered. Since there is some evidence from animal experiments that high doses of amino acids might act nephrotoxic, perhaps rather than further increasing the quantity of amino acids, in the future antiproteolytically acting substances may help in the management of hypercatabolic ARF. Possibly the use of amino acid solutions, enriched with branched chain amino acids, might represent a new approach in the management of negative nitrogen balance in ARF.
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PMID:Hypercatabolism in acute renal failure--mechanisms and therapeutical approaches. 249 56

The treatment of acute renal failure (ARF) in the newborn with hemo- or peritoneal dialysis is technically difficult and may even be contraindicated. As in the adult, continuous arterio-venous hemofiltration (CAVH) may be an alternative therapy. We used CAVH in the treatment of four newborns with ARF of different etiology. Two brachial, one femoral and one umbilical arteries were cannulated as arterial access, while three jugular and one umbilical veins were used as venous return. An Amicon 0.005 m2 Polysulphon Hollow Fiber hemofilter was connected to the patient with shortened pediatric hemodialysis lines. Total blood volume of the extracorporeal circuit was 15 to 22 ml. Before starting the procedure, an initial bolus of heparin was administered to the patient (100 i.u./kg body wt) and a successive continuous heparin administration was provided during the treatment at the rate of 5 to 7 i.u./kg/hr. Hyperalimentation and/or buffer solutions were used as replacement fluids and were administered according to the patient's fluid balance. mean data in the four patients are summarized as follows. The age of the patients ranged from two to 12 days, while the average body weight was about 3 kg. The ultrafiltration rate during the treatment averaged 0.9 ml/min with a plasma flow ranging from 9.8 to 19.6 ml/min. The treatment duration varied from 30 to 86 hrs. The treatment was well tolerated (patients 1 and 2 recovered, and patients 3 and 4 died due to complications unrelated to the treatment). Arterial pressure remained stable during the procedure. Metabolic acidosis, when present, was corrected by increasing the amount of buffer administered. BUN was maintained below 60 mg/dl in three patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of acute renal failure in newborns by continuous arterio-venous hemofiltration. 371 74

A series of 18 patients who had acute posttraumatic acalculous cholecystitis over a 12 year period was presented. An attempt was made to determine the etiologic factors involved in the pathogenesis of the disease. Large amounts of parenteral narcotics administered over a prolonged period were evident in all patients. Narcotic-induced biliary stasis appeared to be the prime factor involved in the genesis of acalculous cholecystitis after trauma. Other factors such as the presence of shock, respiratory failure, acute renal failure, parenteral hyperalimentation, and multiple transfusions were less prevalent and were not temporally related to the onset of the disease.
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PMID:Acute posttraumatic acalculous cholecystitis. 392 61

Clinical and surgical situation and problems of the blood purification as an artificial renal supports, including hemodialysis, hemofiltration and hemoadsorption, were studied especially fields related with treatment of acute renal failure (ARF), surgeries in the patients treated with chronic hemodialysis and supportive care for the cadaveric renal transplantation. ARF: Our experimental data using septic rats showed that hemoadsorption activated host's reticuloendothelial function and consequently increased survival rate of septic rats. Clinically, similar results were observed by the combination of hemodialysis and hemoadsorption, and the survival rate of ARF with multiple organ failure increased to 68% (21 out of 31 cases) from 30% (8 out of 27) in the patients treated with only hemodialysis. Surgery in the chronic hemodialysis patients: One hundred twenty two operations have been done among the patients treated with chronic hemodialysis in our clinic. However, 15 in emergency cases were died within post operative period. There is no operative death in scheduled operations including total esophagectomy and simultanous radical operation of gall bladder cancer and colon cancer. Pre- and post operative supportive management with immunopotentiator, opsonic protein, coagulative factors and intravenous hyperalimentation with branched chain rich amino acid solution should be added routinely to artificial renal supports in pre- and post operative period. Cadaveric renal transplantation: Eighty-seven percent of cadaveric renal transplantation in our clinic were needed artificial renal support in early phase of post transplantation period because of insufficient renal function by acute tubular necrosis. Necessity of the acceptance of brain death category in Japan is strongly pleaded.
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PMID:[Artificial renal supports in surgery--present status and problems]. 408 99

A solution of 8 essential I-amino acids and hypertonic dextrose was administered to 5 patients in acute postoperative renal failure in a program of hyperalimentation designed to decrease the patient's catabolic state and to accrue certain metabolic benefits. A sixth patient receiving intravenous glucose alone served as a control. The pretreatment plasma concentrations of amino acids in all 6 patients did not differ significantly from normal; following intravenous essential amino acids at a dose of approximately 12.6 gm/24 hours, no significant elevations out of the normal range of these substances occurred. Since urinary excretion rates did not dramatically increase, urinary loss was excluded as a possible cause for the failure of increase of plasma concentrations. The results suggest that the administration of an intravenous solution of 1-amino acids and hypertonic dextrose is associated with rapid clearance from the blood of these substances and, with a failure of increased urinary excretion, indirect evidence of amino acid utilization for protein synthesis has been obtained. Histidine supplementation in patients with acute renal failure is probably unnecessary based on the lack of significant decreases in histidine concentrations in these patients.
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PMID:Amino acid metabolism in acute renal failure: influence of intravenous essential L-amino acid hyperalimentation therapy. 485 Apr 97


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