Positive nitrogen balance after intraperitoneal administration of amino acids in 3 patients.

OBJECTIVE

To determine whether intraperitoneal (IP) administration of amino acids improves nitrogen balance during continuous ambulatory peritoneal dialysis (CAPD).

DESIGN

Nitrogen balance studies of CAPD patients comparing periods of peritoneal dialysis using dialysate with nitrogen added from a commercial amino acid solution, versus standard dialysate.

SETTING

Clinical research center in a tertiary facility.

PATIENTS

Patients on CAPD who volunteered.

INTERVENTIONS

One 4-day balance period was carried out with conventional dialysate and one 4-day period with conventional dialysate to which amino acids were added. The study periods were separated by a 3-day washout period.

MAIN OUTCOME MEASURES

Nitrogen accumulation or loss during each period.

RESULTS

The mean (SD) daily control period balances (grams per day) were 0.2, 1.9, and -3.4; during the amino acid period the balances were 5.4, 2.7, -0.7. The mean daily control effluent dialysate volumes (milliliters) were 11,350 +/- 443, 10,052 +/- 449, and 10,165 +/- 154; during the amino acid period the volumes were 10,345 +/- 50, 12,325 +/- 1021, and 10,220 +/- 655.

CONCLUSIONS

The IP addition of amino acids diminishes the amount of nitrogen lost from dialysate while maintaining effluent dialysate volume. Nitrogen balances improved in all 3 patients during the period with IP amino acids, compared to control.