Amino acid balance with extended daily diafiltration in acute kidney injury.
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.
Department of Intensive Care, Austin Hospital, Melbourne, Vic., Australia.
Horng Ruey
HR
Chua
Ian
I
Baldwin
Nigel
N
Fealy
Toshio
T
Naka
Rinaldo
R
Bellomo
D058186:Acute Kidney Injury / Q000097:blood / Q000378:metabolism / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000097:blood* / Q000378:metabolism; D016638:Critical Illness; D015314:Dialysis Solutions / Q000378:metabolism; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism*; D006435:Renal Dialysis / Q000379:methods*
D000596:Amino Acids; D015314:Dialysis Solutions; D009584:Nitrogen