Variability and Lability of Ammonia Levels in Healthy Volunteers and Patients With Cirrhosis: Implications for Trial Design and Clinical Practice.
Am J Gastroenterol
; 115(5): 783-785, 2020 05.
Article
en En
| MEDLINE
| ID: mdl-31449156
ABSTRACT
INTRODUCTION:
Ammonia levels are used to assess hepatic encephalopathy, but their levels are highly variable in clinical practice.METHODS:
We studied factors associated with variation in ammonia values in cirrhotic patients without previous hepatic encephalopathy and healthy volunteers (HVs).RESULTS:
Ammonia increased by 12% and 18% at 1 and 2 hour, respectively, after a protein meal in 64 cirrhotic patients (P < 0.001). In 237 HVs, ammonia levels varied significantly between sites (P < 0.0001). New site-specific ammonia upper limits based on HV levels using a strict analysis protocol differed from routinely used values. Correlation between paired fresh samples was high (r = 0.83) but modest between fresh and frozen samples (r = 0.62).DISCUSSION:
Sample handling, processing, and protein intake impact ammonia levels across sites.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Encefalopatía Hepática
/
Ensayos Clínicos como Asunto
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Amoníaco
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Cirrosis Hepática
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Guideline
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Gastroenterol
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos