title: Blood urea nitrogen and serum bicarbonate in extremely low birth weight infants receiving higher protein intake in the first week after birth.
abstract: OBJECTIVE
  To determine correlation between early protein administration and serum blood urea nitrogen (BUN) or bicarbonate (HCO(3)(-)) in extremely low birth weight (ELBW) infants during the first week of life.
  
  
  METHODS
  A retrospective review of 154 ELBWs was conducted. Laboratory and nutritional data from postnatal days 1, 4 and 7 were collected. Repeated measures models estimated the relationship of protein intake with BUN and HCO(3)(-) in the first week of life.
  
  
  RESULTS
  In total, 359 separate BUN and HCO(3)(-) values were analyzed. Each gram per kilogram of protein administered was associated with an increase in mean BUN of 3.3 mg/dl. This effect decreased daily by 2.1 mg/dl. Each gram per kilogram of protein administered was associated with a decrease in mean HCO(3)(-) by 0.9 mmol/l.
  
  
  CONCLUSIONS
  The association between protein load and BUN is positive but decreasing over time. Protein is associated with a clinically insignificant decrease in HCO(3)(-). Concerns regarding metabolic derangement from early protein administration in ELBWs are unwarranted.
authors.affiliation: Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA.
authors.forename: M
authors.initials: M
authors.lastname: Balakrishnan
authors.forename: R
authors.initials: R
authors.lastname: Tucker
authors.forename: B E
authors.initials: BE
authors.lastname: Stephens
authors.forename: J M
authors.initials: JM
authors.lastname: Bliss
mesh_terms: D001639:Bicarbonates / Q000097:blood*; D001806:Blood Urea Nitrogen; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D004044:Dietary Proteins / Q000008:administration & dosage*; D004655:Emulsions / Q000008:administration & dosage; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000453:epidemiology; D010289:Parenteral Nutrition, Total; D010743:Phospholipids / Q000008:administration & dosage; D012189:Retrospective Studies; D013024:Soybean Oil / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D001639:Bicarbonates; D004044:Dietary Proteins; D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil