Friday, August 14, 2009

56 - Giovanetti diet

A diet designed for patients with renal failure; it provides small amounts of protein, primarily as essential amino acids, along with alpha-keto derivatives of amino acids; breakdown of protein in skeletal muscle is retarded and, because transaminase reactions are reversible, a small proportion of the ammonia released by urea breakdown is used for synthesis of nonessential amino acids.

In patients with ARF, endogenous urea can be converted to non-essential aminoacids if an adequate amount of carbohydrate is provided. The Giordano Giovanetti diet contains a high carbbohydrate diet with limited protein. the use of commercially available essential aminoacids with hypertonic glucose aids control of electrolyte balance, lowers blood urea nitrogen levels, decreases the need for dialysis and speeds recovery of patients with acute tubular necrosis. Using high concentrations of glucose in a small volume allows even an oliguric patient to receive enough calories.

Feinstein employed an interesting approach to providing aminoacids to patients to hemodialysis-dependent renal failure by including them in diasylate .

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