title: Metabolism of albumin after continuous venovenous hemofiltration in patients with systemic inflammatory response syndrome.
abstract: BACKGROUND
  The systemic inflammatory response syndrome (SIRS) is characterized by a hypercatabolic state induced by inflammatory mediators. Continuous venovenous hemofiltration (CVVH) stabilizes the internal environment but also aggravates loss of amino acids. The effect of CVVH on protein dynamics is largely unknown. We adopted the stable isotopic tracer technology to investigate how CVVH changed serum albumin metabolism.
  
  
  METHODS
  Twenty SIRS patients were randomized into low- (2000 mL/h) and high- (4000 mL/h) volume CVVH groups according to the rate of replacement fluid. Eight patients with abdominal infection matched for age, sex, and laboratory index served as controls. Consecutive arterial blood samples were drawn during a primed-constant infusion of two stable isotopes to determine the albumin fractional synthesis rate (FSR) and fractional breakdown rate (FBR).
  
  
  RESULTS
  Before treatment, there was no significant difference of FSR and FBR among 3 groups. After CVVH, the albumin FSR in high- and low-volume groups was 7.75±1.08% and 7.30±0.89%, respectively, both higher than in the control (5.83±0.94%). There was no significant difference in albumin FBR after treatment.
  
  
  CONCLUSIONS
  Protein dynamic indicators could reflect protein synthesis and breakdown state directly and effectively. CVVH increased albumin synthesis, while the breakdown rate remained at a high level independently of the CVVH rate.
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China ; Minimally Invasive Department of General Surgery, Fushun Central Hospital, Fushun, Liaoning 113006, China.
authors: Yu
authors: Y
authors: Chen
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China.
authors: Jianan
authors: 0000-0002-4697-4762
authors: J
authors: Ren
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China.
authors: Xiaodong
authors: X
authors: Qin
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China.
authors: Guanwei
authors: G
authors: Li
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China.
authors: Bo
authors: B
authors: Zhou
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China.
authors: Guosheng
authors: G
authors: Gu
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China.
authors: Zhiwu
authors: Z
authors: Hong
authors: Lab of Metabolomics, Key Lab of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Jiangsu 210002, China.
authors: JiYe
authors: J
authors: Aa
authors: Department of Surgery, Jinling Hospital, Medical School, Nanjing University, 305 East Zhongshan Road, Nanjing, Jiangsu 210002, China.
authors: Jieshou
authors: J
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis* / Q000378:metabolism*; D005260:Female; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology / Q000628:therapy*
chemical_list: D000418:Albumins
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