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Effects of amino acid additives during hemodialysis of children
Insights
Adding amino acids (AA) to dialysis fluid helps reduce nutrient loss in children undergoing dialysis. This essential nutrient supplementation improves outcomes by preventing essential amino acid nitrogen depletion.
Area of Science:
- Nephrology
- Biochemistry
- Pediatrics
Background:
- Dialysis can lead to the loss of essential nutrients, including amino acids (AA).
- Intradialytic amino acid losses can negatively impact patient health, particularly in pediatric populations.
- Understanding these losses is crucial for optimizing dialysis treatment and nutritional support.
Purpose of the Study:
- To quantify intradialytic free amino acid and alpha-amino nitrogen losses during dialysis in children.
- To investigate the effect of adding an amino acid mixture to the dialysate on these losses.
- To determine the optimal concentration of amino acid supplementation in the dialysate.
Main Methods:
- Measured plasma amino acid variations pre- and postdialysis in three children.
- Assessed amino acid losses into the dialysate.
- Studied the impact of varying concentrations (8.5, 17, 34 mg/100 ml) of an amino acid mixture in the dialysate.
- Determined amino acid dialysance and zero flux concentrations.
Main Results:
- Plasma amino acid concentration before dialysis was the primary factor influencing AA losses.
- Individual amino acid dialysance was inversely related to their molecular weight.
- A zero flux for alpha-amino nitrogen was observed at a dialysate concentration of 22 mg/100 ml.
- Nonessential amino acid levels were minimally affected by the dialysate additive.
- Essential amino acid nitrogen levels, which decreased during baseline dialysis, improved significantly with AA supplementation.
Conclusions:
- Amino acid supplementation in the dialysate can effectively mitigate essential amino acid nitrogen losses during dialysis.
- This strategy may help preserve nutritional status in pediatric patients undergoing dialysis.
- Further research into optimal amino acid formulations and concentrations for dialysis is warranted.
Abstract:
The intradialytic losses into the dialysate of free amino acids (AA) and alpha-amino nitrogen were determined during the dialysis of three children. Variations in plasma AA were determined pre- and postdialysis. The effect of these losses with the addition of an Abbott General Amino Acid Mixture to the dialysate in concentrations of 8.5, 17, and 34 mg/100 ml was studied. The major determinant of AA losses was the plasma concentration of the AA before beginning the dialysis treatment. Dialysance of individual AA varied inversely with their molecular weights. A zero flux of alpha-amino nitrogen occurred at a derived concentration of 22 mg/100 ml of the AA additive in the dialysate. Plasma concentrations of nonessential amino acids were little affected by the dialysate additive. In contrast, total essential amino acid nitrogen which fell during baseline dialyses showed significant improvement when the AA solution was added to the dialysate. This study suggests that the addition of AA to the dialysate bath may be effective in decreasing AA nitrogen losses during dialysis.