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Hemodiyaliz hastalarında intradiyalitik parenteral esansiyel amino asit tedavisinin etkileri

Effects of intradialytic parenteral essential amino acid suplementation in hemodialysis

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Abstract (2. Language): 
We administered intradialytic parenteral assential amino acid (EAA) solution to 19 uremic patients with low body mass index (8M. 11 F; mean age : 48±6 years) for 3 months, undergoing hemodialysis (HD) three times per week and investigated the effects of this treatment on some nutritional parameters such as body weight (bw), body mass index (BMI), serum albumin and transferrin levels, protein catabolic rate (PCR), tuberculin skin test (PPD) and total lymphocyte counts. Mean bw of the patients was 52±3.5 kg and HD duration was 12±4 months. Patients received same diet before and during this supplementation period (protein : Ig/kg/day, energy : 35 kcal/kg/day). Two hundred and fifty ml of EAA solution (NephrAmine)R including 12.7 g EAA was administered to each patient during the last 2 hours of each dialysis session three times per week. All patients simultaneously received 500 ml of 10% glucose. In conclusion, we found that intradialytic parenteral EAA administration significantly increased serum albumin and transferrin levels, BMI and PCR values without changing blood urae nitrogen levels and partially improved nutritional status. [Journal of Turgut Özal Medical Center 2(2): 155-159,1995] Key Words : Hemodialysis, essential amino acid supplementation, chronic renal failure, malnutrition, protein catabolic rate.
Abstract (Original Language): 
Vücut kitle indeksleri düşük olan kronik hemodiyaliz (HD) programındaki 19 (11 K, 8 E) üremik hastaya 3 ay süre ile her diyaliz seansının son 2 saatinde 250 ml % 5.4'lük Esansiyel Amino Asit (EAA) solüsyonu ile birlikte 500 ml % 10'luk dekstroz infüzyonu uygulayarak, bu tedavinin; vücut ağırlığı, vücut kitle indeksi (BMI), serum albumin ve transferrin düzeyi, PPD, total lenfosit sayısı ve protein katabolizma hızı (PCR) gibi nutrisyonel parametreler üzerine etkisini araştırdık. Hastaların yaş ortalaması 48±6 (36-60) yıl ve vücut ağırlığı 52±3.5 kg idi. Ortalama 12±4 aydan beri HD'e giriyorlardı. Hastaların tedavi öncesi 1 gfcg/gün protein ve 35 kcal/kg/gün kalori ihtiva eden diyetleri tedavi süresince değiştirilmeden aynen uygulandı. Sonuç olarak; BMl'leri düşük olan kronik HD hastalarında intradiyalitik parenteral EAA infüzyonunun azotemiyi etkilemeksizin BMI, serum albumin ve transferrin düzeyi ile PCR'ı önemli derecede artırarak bozulmuş olan nutrisyonel durumu iyileştirdiği tespit edilmiştir. [Turgut Özal Tıp Merkezi Dergisi 2(2): 155¬159,1995]
155-159

REFERENCES

References: 

1. Toigo G, Situlin R, Tamaro G, Bianco AD, Giuliani V, Dardi F, et al. Effect of intravenous supplemantation of a new essential amino acid formulation in hemodialysis patients. Kidney Int. 1989;36(suppl27):278-81.
2. Guarnieri G, Faccini L, Liparteti T, Raineri F, Spangaro F, et al. Simple methods for nutritional assesment in hemodialized patients. Am J Clin Nutr 1980;33:1598-607.
3. Olshan AR, Bruce J, Sehwartz AB. Intradialytic paranteral nutrition administration during outpatient hemodialysis. Dial Transplant 1987; 16(9): 495-6.
4. Heidland A, Kult J. Long-term effects of essential amino acids supplemantation in patients on regular dialysis treatment. Clin Nephrol 1975;3:234-9.
5. Guarnieri GF, Lucchetti P, Fuccini L, Guintini D, Apollonio R, Pacorari R, et al. Parenteral hyperalimentation with essential amino acids in chronic uremia. In: Proceedings of the 2nd: Donau symposium fur Nephrologie. Friedberg, Verlag Carl Bindernagol 1977:270-80.
6. Synder S, Bergen C, Sigler MH, Teehan BP. Intradialytic parenteral nutrition in chronic hemodialysis patients. ASAIO Trans 1991;37: 373-5.
7. Aviram A, Peters JH, Gulyessy PF. Dialysance of aminoacids and related substances. Nephron 1971;8:440.
8. Bergstrom J, Furst P, Josephson, Noree L-O. Improvement of nitrogen balance in a uremic patient by addition of histidine to essential amino acid solutions given intravenously. Life Sciences 1970:787-94.
9. Russell RM. Nutritional Assesment. In: Wyngaarden JB, Smith LH, Bennett JC, eds. Cecil Textbook of Medicine. 19th ed. Philadelphia: W.B.Saunders 1991:1151-8.
10. Goldstein MB, Jindal KK, Levin A, Stinebaugh BJ. Adequacy of hemodialysis: Assesment and Achievement. In : Jacobson HR, Striker GE, Klahr S, eds. The Principles and practice of Nephrology, Philadelphia: B.C. Decker Inc 1991:749-57.
11. Vanholder RC, Ringoir SM. Adequacy of dialysis: A critical analysis. Kidney Int.
Journal of Turgut Özal Medical Center 2(2): 1995
158
Tonbul ve ark.
Hemodiyaliz hastalarında intradiyalitik parenteral esansiyel amino asit tedavisinin etkileri
1992;42:554-8.
12. Gotch FA. Kinetic modeling in hemodialysis. In: Nissenson AR, Fine RN, Gentile DE, Eds. Clinical Dialysis. 2nd ed. Prentice-Hall International Inc, USA 1990:118-46.
13. Goldstein DJ, Frederico CB. The effect of urea kinetic modeling on the nutrition management of hemodialysis patients. J Am Diet Ass 1987:87(4):474-7.
14. Bilbrey GL, Cohen TL. Identification and
treatment of protein calorie malnutrition inchronic hemodialysis patients, Dial Transplant 1989;18(12):669-700.
15Bergstrom J, Lindholm B. Nutrition and adequacy of dialysis. How do hemodialysis and CAPD compare? Kidney Int 1993;43(40):39-50.
16. Lindsay RM, Heidenheim P, Spanner E, Kortas C, Blake PG, et al . Adequacy of hemodialysis and nutrition, Kidney Int 1994;45(44): 85-91.

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