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  • Title: Amino acid losses and nitrogen balance during slow diurnal hemodialysis in critically ill patients with renal failure.
    Author: Kihara M, Ikeda Y, Fujita H, Miura M, Masumori S, Tamura K, Yabana M, Takagi N, Umemura S, Ishii M.
    Journal: Intensive Care Med; 1997 Jan; 23(1):110-3. PubMed ID: 9037649.
    Abstract:
    OBJECTIVE: The effects of slow diurnal hemodialysis (slow HD) on amino acid losses and nitrogen balance were studied. DESIGN: Slow HD was conducted for 10 h during the day at the dialysate flow rate of 30 ml/min. The patients received total parenteral nutrition including 40 g of amino acids (6.08 g of nitrogen). The amino acid concentrations in plasma and dialysate were determined and the daily nitrogen balance was calculated from the urea nitrogen appearance. PATIENTS: Six critically ill patients with renal failure were entered into the study. RESULTS: Slow HD eliminated 48.5 +/- 4.4 mmol (6.2 +/- 0.6 g) of amino acids, representing 16% of the daily amino acid load. The estimated nitrogen balance was -2.3 +/- 1.3 g/day. Amino acid nitrogen lost in the dialysate was 1.0 +/- 0.1 g, contributing 43% of the daily negative nitrogen balance. CONCLUSION: The amount of amino acid losses during slow HD should be taken into consideration when designing nutritional schedules for maintaining positive nitrogen balance in critically ill patients.
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