Protein Catabolism Following Stroke

To the Editor .—Increased nitrogen loss following surgery, trauma, or sepsis is generally considered as an important component of the metabolic response to injury. Nitrogen loss is measured as the loss of nitrogen or even urea in the urine, and the ratio of nitrogen to creatinine in untimed samples of urine has been used to correct nitrogen excretion for body size. 1 Patients and Methods .—We attempted to evaluate the effect of stroke on protein metabolism by calculating the ratio of urea to creatinine in untimed midmorning urine samples from 29 patients with moderately severe cerebrovascular accident. There were 16 men and 13 women, aged 43 to 85 years. All had normal renal function, as estimated by serum creatinine levels, and were in good nutritional state before stroke. Patients received infusions of 3 L/day 5% dextrose for three days after the acute attack. The course was generally uncomplicated, except in three patients who