Department of Nephrology, Theodor Bilharz Research Institute, Giza, Egypt.
Department of Internal Medicine, Cairo University, Cairo, Egypt.
Saudi J Kidney Dis Transpl. 2020 Nov-Dec;31(6):1361-1365. doi: 10.4103/1319-2442.308346.
Malnutrition in hemodialysis (HD) patients is caused by deficient nutrient and protein intake and has a negative impact on patient outcomes. The assessment of dialysis adequacy in these patients depends to a large extent on the calculation of urea clearance using dialyzer clearance of urea (K) multiplied by the duration of the dialysis treatment (t, in minutes) divided by the volume of distribution of urea in the body (V, in mL); Kt/V. This study aims to detect the effect of branched-chain amino acid (BCAA) supplementation on Kt/V and other nutritional parameters such as serum albumin as well as body mass index. Forty-six patients from the HD Unit of Mostafa Mahmoud Hospital were included in this study. Daily intake of BCAA was continued for three months. At the start of the study, before the intervention, and at the end of the 3 month, we measured serum albumin, valine, leucine, iso-leucine, and Kt/V. Analysis of data was performed using paired and independent t-test. We found that BCAA has a highly significant effect on increasing the level of albumin, leucine, isoleucine, valine, and Kt/V in HD patients (P <0.001) (Paired t-test). BCAA supplements could be used in this patient population to improve dialysis adequacy and outcome.
血液透析(HD)患者的营养不良是由营养和蛋白质摄入不足引起的,对患者的预后有负面影响。这些患者的透析充分性评估在很大程度上取决于使用透析器尿素清除率(K)乘以透析治疗持续时间(t,以分为单位)除以体内尿素分布容积(V,以毫升为单位)来计算尿素清除率(Kt/V)。本研究旨在检测支链氨基酸(BCAA)补充对 Kt/V 和其他营养参数(如血清白蛋白和体重指数)的影响。本研究纳入了 Mostafa Mahmoud 医院 HD 科的 46 名患者。每日持续补充 BCAA 三个月。在研究开始时(干预前)和 3 个月结束时,我们测量了血清白蛋白、缬氨酸、亮氨酸、异亮氨酸和 Kt/V。使用配对和独立 t 检验对数据进行分析。我们发现,BCAA 对增加 HD 患者的白蛋白、亮氨酸、异亮氨酸、缬氨酸和 Kt/V 水平有非常显著的影响(P<0.001)(配对 t 检验)。可以在该患者人群中使用 BCAA 补充剂来提高透析充分性和预后。