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Abstract: SA-PO561

Amino Acid Loss During a Hemodialysis Session Depending on Membrane Materials

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Shirouzu, Tomohiro, 2nd Department of Internal Medicine, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
  • Maeda, Tomokazu, Kitakyushu General Hospital, Kitakyushu, Japan
  • Furuno, Ikutaro, Kidney Center, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
  • Miyamoto, Tetsu, Kidney Center, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
Background

Dialysis-related factors including nutrient loss during a hemodialysis (HD) session may have an important impact on protein energy wasting especially in elderly or malnourished dialysis patients. In this study, we examined dialysate amino acid (AA) loss during a HD session and compared clear space (CS) of AA among three different membranes including acrylonitrile and sodium methallyl sulfonate blend (AN 69) which has significantly smaller amount of albumin loss.

Methods

In 6 maintenance HD patients (6 women), pre-HD plasma basic 20 AA profiles were analyzed in three consecutive HD sessions (blood flow 200ml/min, 4 hours) with different membranes. Simultaneously, dialysate AA losses in each session are measured by continuous effluent collection (2L/hr) from the drainage line. The membranes studied were: cellulose tri-acetate (CTA), polysulfone(PS), and acrylonitrile and AN 69. All membranes had similar surface area of 1.5 square meters. We measured CS using the pre-dialysis plasma AA concentration and AA losses in dialysate, and compared CS among the three membranes.

Results

The total amino acid (TAA) loss for each HD session was 8.2 (5.9-10.0) g for CTA, 8.0 (6.1-9.5) g for PS, and 7.3 (5.0-8.4) g for AN69 (p=0.32). Average of CS for each AA is 21(16-25) L for CTA, 19(16-27) L for PS, 18(15-24)L for AN69 (p=0.36). Total CS for AA is 400(311-474) for CTA, 362 (302-505) L for PS, 344 (292-451)L for AN69 (p=0.36).

Conclusion

A total of 7 to 8 grams of AA are lost per HD session. No superiority of AN69 for reducing AA loss was not observed in this study.