title: [The effect of intradialytic parenteral nutrition (IDPN) on the amino acid pool, a kinetic study].
abstract: BACKGROUND
  Malnutrition in dialysis patients could be offset by intradialytic parenteral nutrition (IDPN), provided it is possible to demonstrate that this technique improves the aminoacid (AA) pool, despite clearance during dialysis.
  
  
  METHODS
  A kinetic study was conducted in 10 malnourished patients, undergoing thrice- weekly low-flux HD, 240 mins/session (Bologna Malpighi and Trento Hospitals, Italy). After an HD session without IDPN (baseline), the patients received an IDPN solution with 16 AAs (all-in-one bag,NutriSpecialipid: 625 ml, Prot 35.9 gr) over a one-month period. At baseline, after 2 and 4 weeks, pre- and post-HD plasma and dialysate AA concentrations were measured.
  
  
  RESULTS
  Even with a low-flux dialyzer and in the absence of IDPN infusion, AA loss in the dialysate occurred, increasing with the addition of IDPN infusion (3.9+0.3 gr/session with no IDPN compared to 7.7+0.5 with IDPN, p=0.00043), accounting foralmost 26% of the infused AA mass. Nevertheless, the AA mass balance was positive in the patients studied (+21.06+0.95 gr AA/session). After a one-month period with IDPN, the pre-dialysis concentration of each AA infused had indeed increased when compared with baseline concentrations, with a mean overall increase of 36.8%. No severe glucose imbalance was reported.
  
  
  CONCLUSIONS
  After a one-month period, overall increase in the plasma concentration of all the infused AAs was observed, supporting the hypothesis that the use of IDPN for longer periods may result in increased protein synthesis.
authors.forename: Marco
authors.initials: M
authors.lastname: Veronesi
authors.forename: Elena
authors.initials: E
authors.lastname: Mancini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Valente
authors.forename: Francesca
authors.initials: F
authors.lastname: Righetti
authors.forename: Giuliano
authors.initials: G
authors.lastname: Brunori
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D015314:Dialysis Solutions / Q000737:chemistry / Q000493:pharmacokinetics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D008567:Membranes, Artificial; D008875:Middle Aged; D010288:Parenteral Nutrition; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation; D055815:Young Adult
chemical_list: D000596:Amino Acids; D015314:Dialysis Solutions; D008567:Membranes, Artificial