Department of Intensive Care, Austin Hospital, Melbourne, Vic., Australia.
Blood Purif. 2012;33(4):292-9. doi: 10.1159/000335607. Epub 2012 May 31.
The impact of hybrid dialysis therapies on amino acid (AA) balance in critically ill patients with acute kidney injury is unknown.
We examined prospectively the AA balance with extended daily diafiltration (EDDF).
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.
AA loss with EDDF was limited, but with much individual variability, and contributed to a strongly negative daily nitrogen balance.
混合透析疗法对急性肾损伤危重症患者氨基酸（AA）平衡的影响尚不清楚。
我们前瞻性地研究了扩展每日透析滤过（EDDF）的 AA 平衡。
我们研究了 7 例患者。EDDF 的 AA 清除率范围为 21.6 ml/min（色氨酸）至 66.9 ml/min（牛磺酸）。接受肠内营养（EN）的患者 AA 丢失量为 4.2（IQR 1.4-12.3）g/天，占每日蛋白质摄入量的 4.5%。EDDF 每小时 AA 丢失率最高的是谷氨酰胺（32.1%），最低的是谷氨酸（0.8%）。血 AA 水平与相应的 EDDF 丢失量相关。接受 EN 的患者的中位总氮摄入量为 25.0（IQR 20.6-29.3）g/天。这导致了每天-10.7（IQR -16.6 至-1.4）g 的负氮平衡，其中 6.5%归因于 AA 丢失。
EDDF 导致的 AA 丢失有限，但个体差异较大，导致每日氮平衡呈强烈负性。
