Amino acid balance with extended daily diafiltration in acute kidney injury
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Updated: May 21, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Horng Ruey Chua1, Ian Baldwin, Nigel Fealy
1Department of Intensive Care, Austin Hospital, Melbourne, Vic., Australia.
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.
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