Sargent J A, Gotch F A, Henry R R, Bennett N
J Am Diet Assoc. 1979 Nov;75(5):551-5.
The concepts of mass balance are extended to the nutritional management of the patient with chronic renal failure on dialysis. The use of these concepts permits estimation of protein catabolism from calculated rates of urea generation, using measurement of blood urea levels. Protein catabolic rate will equal intake in the stable patient (zero nitrogen balance), allowing for accurate nutritional screening in a large dialysis population for whom these values are available without individual dietary surveys. This has resulted in a four-fold reduction in routine monitoring of protein nutrition in such patients, freeing the dietitian to concentrate on specific problems. These concepts also comprise a key aspect of the National Cooperative Dialysis Study which seeks to maintain BUN at different levels in four carefully controlled modes of dialysis therapy. With these methods, the monitoring and control of BUN and protein intake has made the dietitian a pivotal member of this study staff.
质量平衡的概念被扩展到接受透析治疗的慢性肾衰竭患者的营养管理中。运用这些概念，可以通过测量血尿素水平，根据计算出的尿素生成速率来估算蛋白质分解代谢。在稳定状态的患者中，蛋白质分解代谢率将等于摄入量（零氮平衡），这使得在大量透析人群中无需进行个体饮食调查就能获得这些数值，从而进行准确的营养筛查。这使得此类患者蛋白质营养的常规监测减少了四倍，使营养师能够专注于特定问题。这些概念也是全国合作透析研究的一个关键方面，该研究旨在通过四种精心控制的透析治疗模式将血尿素氮维持在不同水平。通过这些方法，血尿素氮和蛋白质摄入量的监测与控制使营养师成为该研究团队的关键成员。
