Comparison of Intradialytic Parenteral Nutrition with Glucose or Amino Acid Mixtures in Maintenance Hemodialysis Patients.
Many long-term maintenance hemodialysis patients have symptoms of protein-energy wasting caused by malnutrition. Each session of hemodialysis removes about 10 to 12 g of amino acids and 200 to 480 kcal of energy. Patients receiving hemodialysis for chronic kidney disease may be undernourished for energy, protein consumption, or both. Non-diabetic hemodialysis patients were randomized to three treatment groups: oral supplementation, oral supplementation plus high-concentration glucose solution (250 mL containing 50% glucose) and these two interventions plus 8.5% amino acids solution. The post-treatment energy status of the glucose group was significantly higher than its baseline level, whereas the control group's status was significantly lower. The glucose group had significantly higher concentrations of asparagine, glutamine, glycine, alanine, and lysine after treatment. All treatment groups had significantly increased hemoglobin levels but significantly decreased transferrin levels after treatment compared to baseline. After treatment, the amino acid group had significantly higher albumin level compared to the glucose group (p = 0.001) and significantly higher prealbumin level compared to the control group (p = 0.017). In conclusion, long-term intervention with high-concentration glucose solution at each hemodialysis session is a simple and cheap method that replenished energy stores lost during hemodialysis of non-diabetic patients.
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. rabbityan127@163.com.|Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou 510220, China. rabbityan127@163.com.
Yan
Y
Liu
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. XiaoXiao9943@sina.com.
Xiao
X
Xiao
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. DanpingQin11@163.com.
Dan-Ping
DP
Qin
Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou 510220, China. rongshaotan01@sina.com.
Rong-Shao
RS
Tan
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. XiaoshiZhong33@163.com.
Xiao-Shi
XS
Zhong
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. daoyuanzhou15@sina.com.|Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou 510220, China. daoyuanzhou15@sina.com.
Dao-Yuan
DY
Zhou
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. yunliu0223@sina.com.|Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou 510220, China. yunliu0223@sina.com.
Yun
Y
Liu
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. xuanxiong10@sina.com.
Xuan
X
Xiong
Department of Nephrology, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China. yuanyuanzheng22@sina.com.
Yuan-Yuan
YY
Zheng
D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000008:administration & dosage*; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010288:Parenteral Nutrition; D011228:Prealbumin / Q000032:analysis; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D014168:Transferrin / Q000032:analysis
D000596:Amino Acids; D006454:Hemoglobins; D011228:Prealbumin; D012709:Serum Albumin; D014168:Transferrin; D005947:Glucose
IDPN; PEW; amino acid supplementation; chronic kidney disease; glucose supplement; hemodialysis; nutritional intervention; protein energy wasting