Amino acid clearances and daily losses in patients with acute renal failure treated by continuous arteriovenous hemodialysis.

Abstract:

OBJECTIVE:To determine daily amino acid and total protein losses in patients with acute renal failure receiving total parenteral nutrition (TPN) during treatment by continuous arteriovenous hemofiltration with hemodialysis (CAVHD). DESIGN:Prospective, nonrandomized study. SETTING:Patients in the ICU of a regional nephrology referral center. PATIENTS:Eight clearance studies of individual amino acids were performed in six patients with acute renal failure receiving TPN. Daily nitrogen intake was 9 g (one patient), 14 g (two patients), and 18 g (three patients). The clearances of individual amino acids were measured at two dialysis flow rates to calculate daily amino acid and total proten losses. RESULTS:Amino acid clearance rates ranged from 7.8 +/- 2.2 (glutamic acid) to 25.2 +/- 4.8 mL/min (3-methylhistidine) at a dialysate flow rate of 1 L/hr and from 13.6 +/- 1.7 (tryptophan) to 33.7 +/- 4.3 mL/min (3-methylhistidine) at a dialysate flow rate of 2 L/hr. These results represent daily amino acid losses of 1.5 +/- 0.4% (glutamic acid) to 111.6 +/- 16.6% (tyrosine) of the nutritional input at a dialysate flow rate of 1 L/hr and 2.1 +/- 0.6% (glutamic acid) to 145.8 +/- 17.8% (tyrosine) at a dialysate flow rate of 2 L/hr. Total losses would represent 8.9 +/- 1.2% and 12.1 +/- 2.2%, respectively, of the daily protein input. CONCLUSIONS:These studies confirm that amino acid clearances are relatively high during CAVHD and daily losses should therefore be considered.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Davies SP,Reaveley DA,Brown EA,Kox WJ

doi

10.1097/00003246-199112000-00012

subject

Has Abstract

pub_date

1991-12-01 00:00:00

pages

1510-5

issue

12

eissn

0090-3493

issn

1530-0293

journal_volume

19

pub_type

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