Clinical evaluation of an optimized 1.1% amino-acid solution for peritoneal dialysis.
A significant percentage of dialysed patients have inadequate protein intake. One strategy for treating the protein malnutrition in peritoneal dialysis patients is to replace glucose in the dialysis solution by amino acids. A new peritoneal dialysis solution containing 1.1% amino acids in a formulation optimized for renal patients and with a lactate concentration of 40 mmol/l has been evaluated. Fifteen CAPD patients completed a non-randomized prospective 3-month study. Each patient received 2 litres of the optimised 1.1% amino acid solution for the second exchange of the day with a dwell time of 5-6 h. Indicators of efficacy were serum albumin and transferrin. After 3 months of intraperitoneal amino acids, serum albumin levels significantly increased from 32.7 +/- 2.3 to 35.1 +/- 2.2 g/l (mean +/- SD; P < 0.01). This occurred in parallel with a significant increase in transferrin levels from 2.21 +/- 0.26 to 2.39 +/- 0.27 g/l (P < 0.05). As expected, urea rose from 23.7 +/- 6.8 to 29.9 +/- 9.4 mmol/l. Interestingly bicarbonate did not change (25.5 +/- 4.2 versus 25.2 +/- 3.3 mmol/l). These results suggest that the optimized formulation is effective in improving nutritional parameters in CAPD patients while avoiding unwanted side-effects such as acidosis.
Faller
B
B
Hôpital Louis Pasteur, Colmar, Belgium.
Aparicio
M
M
Faict
D
D
De Vos
C
C
de Précigout
V
V
Larroumet
N
N
Guiberteau
R
R
Jones
M
M
Peluso
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D009752:Nutritional Status; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D014168:Transferrin / Q000378:metabolism*
D000596:Amino Acids; D015314:Dialysis Solutions; D012709:Serum Albumin; D014168:Transferrin