BACKGROUND: The impact of hybrid dialysis therapies on amino acid (AA) balance in critically ill patients with acute kidney injury is unknown. METHODS: We examined prospectively the AA balance with extended daily diafiltration (EDDF). RESULTS: We studied 7 patients. AA clearances with EDDF ranged from 21.6 ml/min (tryptophan) to 66.9 ml/min (taurine). AA loss was 4.2 (IQR 1.4-12.3) g/day and 4.5% of daily protein intake for patients on enteral nutrition (EN). Percentage AA loss per hour on EDDF was highest for glutamine (32.1%) and lowest for glutamic acid (0.8%). Blood AA levels correlated with corresponding EDDF losses. Median total nitrogen appearance was 25.0 (IQR 20.6-29.3) g/day for patients on EN. This resulted in a negative nitrogen balance of -10.7 (IQR -16.6 to -1.4) g/day, of which 6.5% was attributable to AA loss. CONCLUSIONS:AA loss with EDDF was limited, but with much individual variability, and contributed to a strongly negative daily nitrogen balance.
RCT Entities:
BACKGROUND: The impact of hybrid dialysis therapies on amino acid (AA) balance in critically illpatients with acute kidney injury is unknown. METHODS: We examined prospectively the AA balance with extended daily diafiltration (EDDF). RESULTS: We studied 7 patients. AA clearances with EDDF ranged from 21.6 ml/min (tryptophan) to 66.9 ml/min (taurine). AA loss was 4.2 (IQR 1.4-12.3) g/day and 4.5% of daily protein intake for patients on enteral nutrition (EN). Percentage AA loss per hour on EDDF was highest for glutamine (32.1%) and lowest for glutamic acid (0.8%). Blood AA levels correlated with corresponding EDDF losses. Median total nitrogen appearance was 25.0 (IQR 20.6-29.3) g/day for patients on EN. This resulted in a negative nitrogen balance of -10.7 (IQR -16.6 to -1.4) g/day, of which 6.5% was attributable to AA loss. CONCLUSIONS: AA loss with EDDF was limited, but with much individual variability, and contributed to a strongly negative daily nitrogen balance.
Authors: Sandra N Stapel; Ruben J de Boer; Patrick J Thoral; Marc G Vervloet; Armand R J Girbes; Heleen M Oudemans-van Straaten Journal: Blood Purif Date: 2019-07-10 Impact factor: 2.614
Authors: Peter J M Weijs; Luc Cynober; Mark DeLegge; Georg Kreymann; Jan Wernerman; Robert R Wolfe Journal: Crit Care Date: 2014-11-17 Impact factor: 9.097
Authors: Weng C Oh; Bruno Mafrici; Mark Rigby; Daniel Harvey; Andrew Sharman; Jennifer C Allen; Ravi Mahajan; David S Gardner; Mark A J Devonald Journal: Kidney Int Rep Date: 2019-05-23