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Protein losses in continuous renal replacement therapies
1Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Journal of the American Society of Nephrology : JASN
|October 1, 1996
Summary
Continuous renal replacement therapy (CRRT) results in significantly lower protein losses than previously thought. These losses depend on serum protein levels and the CRRT method used, ranging from 1.2 to 7.5 g/day.
Area of Science:
- Nephrology
- Intensive Care Medicine
- Biochemistry
Background:
- Continuous renal replacement therapy (CRRT) is a critical care treatment.
- Previous studies using less sensitive assays reported high protein losses during CRRT.
- Accurate quantification of protein loss is essential for patient management.
Purpose of the Study:
- To re-evaluate protein losses during CRRT using a highly sensitive assay.
- To determine the factors influencing protein loss during CRRT.
Main Methods:
- Analyzed 22 dialysate/ultrafiltrate samples from CRRT treatments (CVVH, CVVHD/F).
- Utilized a sensitive pyrogallol red microprotein reagent for protein quantification.
- Correlated protein losses with serum protein concentration and CRRT modality.
Main Results:
- Mean protein concentration in dialysate/ultrafiltrate was 4.2 ± 4.0 mg/dL, significantly lower than previously reported.
- Protein losses were higher with convection-dominant CVVH (6.0 ± 5.1 mg/dL) than diffusion-based CVVHD/F (2.7 ± 1.9 mg/dL).
- A weak but significant correlation was found between dialysate/ultrafiltrate and serum protein levels.
Conclusions:
- Protein losses during CRRT are substantially lower than previously estimated.
- Protein loss is influenced by serum protein concentration and the CRRT method (convection vs. diffusion).
- Estimated daily protein losses range from 1.2 to 7.5 g/day.