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
em 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
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encefalopatia Hepática
/
Ensaios Clínicos como Assunto
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Amônia
/
Cirrose Hepática
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
Limite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Am J Gastroenterol
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos