[Effect of L-lysine-induced amino acid imbalance on nitrogen balance in patients treated by total parenteral nutrition]

Abstract

Cumulative nitrogen balances of 109 patients in 3 groups under total parenteral nutrition were studied with regard to their daily intake of l-lysin. Patients in group 1 who received a mean daily amount of 4.5 g l-lysin exclusively from the amino-acid solution showed a cumulative nitrogen balance of -51.9 g N 10 days into the study. Patients in groups 2 and 3 received, additionally, l-lysin HCl for prophylaxis or therapy of metabolic alkalosis. Thus patients in group 2 received 5.3 g l-lysin (nitrogen balance -101.4 g N/10 days) and in group 3, 8.5 g l-lysin (nitrogen balance -97.6 g N/10 days). The markedly higher negative nitrogen balance in these groups is interpreted as the effect of an amino acid imbalance due to inadequate l-lysin intake; therefore, l-lysin should no longer be used for treatment of metabolic alkalosis in patients under total parenteral nutrition.