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Abstract: FR-PO762

The Amino Acid Losses Are Equal Between Pre and Post On-line HDF Under the Same Dialysis Dose (Kt/V)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Urabe, Shunichiro, Eijin Clinic, Hiratsuka, KANAGAWA, Japan
  • Kato, Motoko, Eijin Clinic, Hiratsuka, KANAGAWA, Japan
  • Hiyama, Emi, Eijin Clinic, Hiratsuka, KANAGAWA, Japan
  • Kurii, Asami, Eijin Clinic, Hiratsuka, KANAGAWA, Japan
  • Hyodo, Toru, Eijin Clinic and Cambodian Association of Nephrology, Hiratsuka, Kanagawa, Japan
  • Kitamura, Makoto, Kurata Hospital, Hiratsuka, Kanagawa, Japan
  • Hida, Miho, Kurata Hospital, Hiratsuka, Kanagawa, Japan
  • Kurata, Yasuhisa, Kurata Hospital, Hiratsuka, Kanagawa, Japan
  • Kokubo, Kenichi, Kitasato University School of Allied Health Sciences, Sagamihara, KANAGAWA, Japan
Background

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

Methods

We compared the total amino acid, total non-essential/essential/branched-chain amino acid amount into the total waste fluid, and Kt/V (urea) between 9 patients undergoing Pre-HDF (7 males, 4 diabetic, mean age: 72.4±2.1 years) and the same patients receiving Post-HDF.
The mean blood flow rate in the former and latter was 222.2±24.8 and 200.0±0.0 mL/min, respectively. The dialysate flow rate was 328.7±48.6 and 556.0±0.0 mL/min, respectively. The replacement fluid flow rate was 251.3±27.4 and 44.0±0.0 mL/min, respectively. The replacement fluid volume was 56.7±6.2 and 10.0±0.0 L, respectively.

Results

In the Pre-HDF group, the total and total non-essential amino acid losses (4814.3±1055.6 and 3058.4±632.0 mg, respectively) were not significantly different from in the Post-HDF group (5257.3±698.9 and 3421.9±446.8 mg, respectively) (p = 0.180 and 0.116, respectively). In the former, the total essential amino acid (1755.9±503.3 mg) was not significantly different from in the latter (1835.3±351.0 mg) (P=0.401) and also in the former, the branched-chain amino acid (780.2±224.2 mg) was not significantly in the latter (816.4±210.1 mg) (P=0.139).
In the Pre-HDF group, the urea and Cr reduction rates were 69.5±7.4 and 63.2±6.7%, respectively. In the Post-HDF group, the values were 70.9±4.4 and 64.8±3.9%, respectively. The values showed no significant differences between the Pre-HDF and Post-HDF group (Urea: P=0.354, Crea: P=0.309). The Kt/V (urea) values in the former and latter were 1.46±0.28 and 1.45±0.19, respectively; there was no significant difference (p=0.862).

Conclusion

Under the same dialysis dose of Kt/V for urea, the amino acid losses were same between Pre-HDF and Post-HDF, suggesting that the moderate volume Post-HDF (replacement fluid volume: around 10.0 L) is as favorable as the Pre-HDF as a blood purification method from the viewpoint of nutrition.