Document Detail

High protein intake during continuous hemodiafiltration: impact on amino acids and nitrogen balance.
MedLine Citation:
PMID:  12027135     Owner:  NLM     Status:  MEDLINE    
AIMS: To study the effect of combined continuous veno-venous hemodiafiltration (CVVHDF) and high (2.5 g/kg/day) parenteral amino acid supplementation on nitrogen balance, amino acid losses and azotemic control in a cohort of patients with severe acute renal failure (ARF). METHODS: We administered 2.5 grams/kg/day of amino acids intravenously to seven critically ill patients with ARF. We obtained paired blood and ultrafiltrate (UF) samples (n=20) and calculated amino acid clearances and losses, nitrogen balance, protein catabolic rate and total nitrogen losses. RESULTS: The median total serum amino acid concentration was high at 5.2 mmol/L with particularly high concentrations of ornithine, lysine, and phenylalanine, but a low level of histidine. The median overall amino acid clearance was 18.6 ml/min (range: 12 to 29 ml/min). UF losses as percentage of administered dose were high for tyrosine (53.6%) but low for methionine (3.0%) and arginine (2.3%). A positive nitrogen balance was achieved in 7 (35%) of the 20 study days with an overall median nitrogen balance of -1.8 g/day. Urea levels were maintained at a median of 26.6 mmol/L. CONCLUSIONS: High protein intake increases the serum concentrations of most amino acids. Such protein supplementation, when coupled with CVVHDF achieves a slightly negative overall nitrogen balance in extremely catabolic patients while still allowing adequate azotemic control.
R Bellomo; H K Tan; S Bhonagiri; I Gopal; J Seacombe; M Daskalakis; N Boyce
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  25     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-11-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  261-8     Citation Subset:  IM    
Intensive Care Unit, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia.
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MeSH Terms
Amino Acids / administration & dosage*,  blood*
Dietary Proteins / administration & dosage*
Food, Formulated*
Kidney Failure, Acute / metabolism*,  therapy
Middle Aged
Nitrogen / metabolism*
Parenteral Nutrition*
Reg. No./Substance:
0/Amino Acids; 0/Dietary Proteins; 65072-01-7/Travasol; 7727-37-9/Nitrogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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