Abstract
It was reported that amino acid infusion during hemodialysis is useful for improving nutritional status. The optimal administration method of amino acid infusion under the high-volume pre-dilution on-line HDF (HVPO-HDF) was analyzed in this study. Subjects were 10 patients on maintenance dialysis at our clinic. We performed high-volume pre-dilution on-line HDF. We investigated two methods for administration of Neoamiyu® 200-ml total amino acid (TAA) infusion for patients with renal failure: (1) continuous infusion into the dialysis circuit for 4 h from the start of dialysis to its completion (infusion rate 50 ml/h) and (2) continuous infusion started 1 h before completion of dialysis (infusion rate 200 ml/h), and compared pre- and post-dialysis blood concentrations and leakage of TAA, essential amino acids (EAA), and nonessential amino acids (NEAA) between these methods. Pre-dialysis blood concentrations of amino acids showed no difference between both the groups. Post-dialysis blood concentrations of amino acids were higher in all concentrations were significantly higher with continuous infusion starting 1 h before completion of dialysis. Leakage of amino acids showed no difference between both the groups. The continuous intradialytic amino acid infusion from the start of dialysis is better to avoid catabolism under high-volume pre-dilution on-line HDF.
This is a preview of subscription content, log in via an institution to check access.
References
Nitta K, Goto S, Masakane I, et al. Annual dialysis date report for 2018, JSDT Renal Date Registry: survey methods, facility date, incidence, prevalence, and mortality. Ren Replace Ther. 2020;6:41.
Kim JK, Choi SR, Choi MJ, et al. Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease. Clin Nutr. 2014;33:64–8.
Ren H, Gong D, Jia F, et al. Sarcopenia in patients undergoing maintenance hemodialysis: incidence rate, risk factors and its effect on survival risk. Ren Fail. 2016;38:364–71.
Johansen KL, Chertow GM, Jin C, et al. Significance of frailty among dialysis patients. J Am Soc Nephrol. 2007;18:2960–7.
Cano NJ, Aparicio M, Brunori G, et al. ESPEN guidelines on parenteral nutrition: adult renal failure. Clin Nutr. 2009;28:401–14.
McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N). JPEN J Parenter Enteral Nutr. 2016;40:159–211.
Löfberg E, Essén P, McNurlan M, Wernerman J, Garlick P, Anderstam B, et al. Effect of hemodialysis on protein synthesis. Clin Nephrol. 2000;54:284–94.
Mokrzycki MH, Kaplan AA. Protein losses in continuous renal replacement therapies. J Am Soc Nephrol. 1996;7:2259–63.
Davies SP, Reaveley DA, Brown EA, Kox WJ. Amino acid clearances and daily losses in patients with acute renal failure treated by continuous arteriovenous hemodialysis. Crit Care Med. 1991;19:1510–5.
Schepky AG, Bensch KW, Schulz-Knappe P, Forssmann WG. Human hemofiltrate as a source of circulating bioactive peptides: determination of amino acids, peptides and proteins. Biomed Chromatogr. 1994;8:90–4.
Ikizler TA, Pupim LB, Brouillette JR, et al. Hemodialysis stimulates muscle and whole body protein loss and alters substrate oxidation. Am J Physiol Endocrinol Metab. 2002;282:e107–16.
Raj DS, Zager P, Shah VO, Dominic EA, Adeniyi O, Blandon P, et al. Protein turnover and amino acid transport kinetics in end-stage renal disease. Am J Physiol Endocrinol Metab. 2004;286:E136–43.
Yamashita AC, Yoshimoto T, Yoshimoto K, et al. Methodological consideration on measurement of removed solute amount. J Jpn Soc Dial Ther. 1982;15:803–7 (in Japanese).
Marsen TA, Beer J, Mann H. Intradialytic parenteral nutrition in maintenance hemodialysis patients suffering from protein-energy wasting. Results of a multicenter, open, prospective, randomized trial. Clin Nutr. 2017;36:107–17.
Anderson J, Peterson K, Bourne D, et al. Effectiveness of intradialytic parenteral nutrition in treating protein- energy wasting in hemodialysis: a rapid systematic review. J Ren Nutr. 2019;29:361–9.
Isaka Y, Kanno Y, Hanafusa N, et al. Recommendations for parenteral and enteral nutrition in patients on chronic maintenance hemodialysis. J Jpn Soc Dial Ther. 2020;53:373–91 (in Japanese).
Tsubakihara Y, Iida N, Yuasa S, et al. Catabolic stress to nitrogen (N) metabolism and essential amino acid (EAA) supplementation in hemodialysis (HD). Nihon Jinzo Gakkai Shi. 1982;24:1127–36 (in Japanese).
Urabe S, et al. Amino acid losses are lower during pre-dilution on-line HDF than HD of the same Kt/V for urea. J Artif Organs. 2020;23:342–7.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Kato, M., Urabe, S., Matsuzawa, S. et al. Continuous intradialytic amino acid infusion from the start of dialysis is better to avoid catabolism under the high-volume pre-dilution on-line HDF. J Artif Organs 25, 377–381 (2022). https://doi.org/10.1007/s10047-022-01319-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10047-022-01319-2