Abstract: FR-PO817

The Amino Acid Losses Are Lower during Pre-Dilution On-Line HDF Than HD

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Urabe, Shunichiro, Eijin Clinic, Hiratsuka, Kanagawa, Japan
  • Kurata, Yasuhisa, Kurata Hospital & Eijin Clinic, Hiratsuka, Japan
  • Kokubo, Kenichi, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
  • Kitajima, Yukie, Tokyo Healthcare University, Tokyo, Japan
  • Kato, Motoko, Eijin Clinic, Hiratsuka, Kanagawa, Japan
  • Kurii, Asami, Eijin Clinic, Hiratsuka, Kanagawa, Japan
  • Hiyama, Emi, Eijin Clinic, Hiratsuka, Kanagawa, Japan
  • Hosono, Takashi, Eijin Clinic, Hiratsuka, Kanagawa, Japan
  • Hyodo, Toru, Kurata Hospital & Eijin Clinic, Hiratsuka, Japan
  • Kitamura, Makoto, Kurata Hospital & Eijin Clinic, Hiratsuka, Japan
  • Hida, Miho, Kurata Hospital & Eijin Clinic, Hiratsuka, Japan
Background

We analyzed the amino acid losses that occur on performing pre-dilution on-line HDF (O-HDF) and HD because the amino acid kinetics of O-HDF has been unknown until now.

Methods

We compared the total amino acid level, total non-essential/essential/branched-chain amino acid levels, urea/Cr removal amount, reduction rate, and Kt/V (urea) between 10 patients undergoing O-HDF (8 males, 5 diabetic, mean age: 70.5±2.11 years) and 10 patients receiving HD (7 males, 5 diabetic, mean age: 73.6±5.87 years). The mean blood flow rate in the former and latter was 240±20 and 200 mL/min, respectively. The dialysate flow rate was 347±26.4 and 450 mL/min, respectively. The replacement fluid flow rate was 253±26.4 and 0 mL/min, respectively. The replacement fluid volume was 57±6.0 and 0 L, respectively.

Results

In the O-HDF group, the total and total non-essential amino acid losses (6,097±1,507* and 4,070±967* mg, respectively) were significantly lower than in the HD group (9,093±1,965 and 6,529±1,469 mg, respectively) (* p < 0.01). Urea and Cr removal amount in the O-HDF group was 12.4±1.48 and 1.59±0.367 g, respectively. In the HD group, the values were 12.5±3.59 and 1.63±0.332 g, respectively. The values showed no significant differences between the O-HDF and HD group. In the O-HDF group, the urea and Cr reduction rates were 65.1±6.68 and 71.2±6.80%, respectively. In the HD group, the values were 64.2±5.95 and 70.6±6.01%, respectively. The values showed no significant differences between the O-HDF and HD group. The Kt/V (urea) values in the former and latter were 1.50±0.289 and 1.49±0.314, respectively; there was no significant difference.

Conclusion

Under the same dialysis dose of Kt/V for urea, the amino acid losses were lower during O-HDF than HD, suggesting that O-HDF is more favorable as a blood purification method from the viewpoint of nutrition.