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Clinical Chemistry 36: 752-755, 1990;
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Clinical Chemistry, Vol 36, 752-755, Copyright © 1990 by American Association for Clinical Chemistry

Chemiluminescent measurement of total urinary nitrogen for accurate calculation of nitrogen balance

KJ Skogerboe, RF Labbe, RL Rettmer, JP Sundquist and AM Gargett
Department of Laboratory Medicine, University of Washington, Seattle 98195.

This instrumental method for total urinary nitrogen (TUN) is based on the principle of gas-phase chemiluminescence. Results correlate well with measurements of TUN by the Kjeldahl method, which has long provided the means to calculate nitrogen balances for nutritional management. In recent years, because of speed and convenience of measurement, determination of urinary urea nitrogen (UUN) has been substituted for Kjeldahl TUN. However, in patients requiring aggressive nutritional support, the UUN may not be a valid indicator of total nitrogen excretion. We compared nitrogen balances calculated for patients, using both UUN and chemiluminescence TUN data. For both normal and hospitalized populations, nitrogen balance calculated from UUN data exceeded that calculated from TUN data. We show that use of UUN data in calculating nitrogen balance may result in an incorrect assessment of many patients as being in positive nitrogen balance. TUN determined by chemiluminescence evidently provides a simple means of calculating nitrogen balance more nearly accurately.


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