Corticosteroid-Induced Changes in Urea Metabolism in Patients with Hepatocellular Disease

Quantitative studies of urea metabolism have been made by a kinetic technique using 13 C urea in 8 patients with hepatocellular disease before and after a 13-day course of prednisolone. After treatment the mean plasma urea concentration was higher in every case, the increases varying between 4 and 22 mg per 100 ml ( P P > 0.05). It is inferred that the liver in patients with hepatocellular disease usually has the capacity to increase the synthetic rate of urea appreciably in response to an appropriate stimulus. The data can be adequately explained in terms of the known effects of corticosteroids on nitrogen metabolism including the catabolic effect of these drugs on protein metabolism in peripheral tissues. The results imply that corticosteroids increase the turnover of nonprotein nitrogenous compounds of small molecular weight, including ammonia, in patients with liver disease.