Use of essential amino acid/dextrose solutions in the nutritional management of patients with acute renal failure.

A review of the literature on the effectiveness of essential amino acid and hypertonic dextrose in the nutritional management of patients with acute renal failure is evaluated critically. Earlier case reports and studies published indicated that the administration of these solutions could lead to lower blood urea nitrogen concentrations, positive nitrogen balance, and various other clinical and metabolic improvements. Recent studies, however, show that various combinations of essential and nonessential amino acids can provide similar results. Some investigators have suggested increasing the concentration of branched-chain amino acids in these solutions to decrease protein catabolism in muscle. Unfortunately, patients with complications such as sepsis, burns, and shock may not benefit from any of these therapies. Further research is needed to elucidate fully the optimal composition of these solutions in severely stressed hypercatabolic patients with this disorder.