Document Detail

Liver test alterations with total parenteral nutrition and nutritional status.
MedLine Citation:
PMID:  1640633     Owner:  NLM     Status:  MEDLINE    
Liver test abnormalities are a well-recognized complication in the parenterally fed population. Numerous etiologies for the development of elevated liver tests have been suggested. However, the etiology and clinical significance remain unclear. The aim of this retrospective study was to determine the extent of liver-associated test (LAT) abnormalities in patients receiving total parenteral nutrition (TPN) and to investigate whether the composition of TPN solutions and the magnitude of malnutrition could be used to predict subsequent LAT abnormalities. Medical records of 78 adult patients who received TPN for at least 2 weeks were reviewed. All subjects had normal LAT results before TPN, were not receiving hepatotoxic drugs, and had no underlying liver disease. Aspartate aminotransferase peaked transiently during week 2 and returned to normal during week 4. Alkaline phosphatase and total bilirubin peaked during weeks 4 and 3, respectively. The average nonprotein kilocalorie distribution was approximately 80% dextrose and 20% lipid. Caloric intake ranged from 7% to 23% above estimated needs. The mean nutritional status score was 22 +/- 15, with a possible range of 0 to 75 (0 indicates no malnutrition). The composition of TPN solutions was not significantly associated with the changes in the three LATs during any week of the 4-week study. The nutritional status score was significantly associated (p less than .05) with the change in alkaline phosphatase during week 1. This study confirms that LAT abnormalities occur during TPN, but the composition of the solution has no significant ability to predict subsequent LAT abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)
L A Leaseburge; N J Winn; P R Schloerb
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  16     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:    1992 Jul-Aug
Date Detail:
Created Date:  1992-09-03     Completed Date:  1992-09-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  348-52     Citation Subset:  IM    
Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City 66103.
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MeSH Terms
Alkaline Phosphatase / blood
Aspartate Aminotransferases / blood
Bilirubin / blood
Energy Intake
Liver Function Tests*
Middle Aged
Nutritional Status*
Parenteral Nutrition, Total / adverse effects*
Retrospective Studies
Grant Support
Reg. No./Substance:
635-65-4/Bilirubin; EC Aminotransferases; EC Phosphatase

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