Urine Urea Nitrogen Loss as a Marker of Catabolism

As part of the host response to injury, infection, or tumor, patients frequently lose protein in the urine in the form of nitrogen. For example, 16 g of urea nitrogen in the urine per day represents a 1-lb loss of lean body mass, such as muscle tissue. In some aggressive cancers, urea nitrogen loss can be as high as 24 g per day. The loss of 1g of urinary urea nitrogen is equal to 6.25 g of dry protein. A total of 6.25 g of dry protein is equal to approximately 1 oz. of lean body mass. A loss of 16 g of urinary urea is equal to the loss of 1 lb of skeletal muscle or lean body mass per day. Specific areas of lean body mass loss that may result in a functional impairment of the respiratory muscles include the diaphragm, heart muscle, and GI mucosa. The loss of lean body mass in these areas can contribute to the development of respiratory failure, heart failure, and diarrhea, respectively. The rapid development of malnutrition can occur in patients with infection due to large losses of lean body mass per day.

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