Case Report Full Protein Alimentation and Nitrogen Equilibrium in a Renal Failure Patient Treated With Continuous Hemodiafiltration: A Case Report of 67 Days of Continuous Hemodiafiltration

ABSTRACT. Standard care for patients with renal failure while in an intensive care unit involves traditional hemodialysis or peritoneal dialysis and protein restriction. We present a case of a patient with renal failure supported with continuous arte-riovenous hemofiltration with dialysis (CAVH-D) who was given full protein alimentation. Total daily urea clearance was measured from the CAVH-D output. Protein load was 196 ± 34 g/day while receiving total parenteral nutrition and 164 ± 30 g/day while receiving enteral alimentation. Serum blood urea nitrogen was controlled between 40 and 75 mg/dL, except during septic episodes. Nitrogen balance was estimated based upon known alimentation protein load and measurable and estimated nitrogenous losses. The patient was potentially in nitrogen equilibrium during most of the dialysis period. The cumulative nitrogen balance was positive by 5.2 g after 67 day