Amino Acid and Protein Losses in Adult Patients Receiving Maintenance Dialysis: A Literature Review.

IF 3.2
Bruno Mafrici, Daniela Viramontes-Hörner, David S Gardner, Kenneth Smith, Maarten W Taal, Nicholas M Selby, Matt Hall
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Abstract

Background: A comprehensive, scoping review was initiated with the aim of providing an update regarding amino acid/protein losses in maintenance hemodialysis/hemodiafiltration (HD/HDF), peritoneal dialysis (PD), home HD (HHD), and nocturnal HD (NHD).

Methods: From 2000 to 2024, all records that measured amino acid and peptide/protein losses in the dialysate effluent were included.

Results: Twenty-nine eligible records were identified (14 HD/15 PD). Amino acid losses ranged from 9.3 ± 2.9 g to 12.0 ± 2.0 g per 4-hour HD session and 0.314 g to 0.522 g/day in PD. Albumin losses ranged from 0.448 g to 3.99 g per HD/HDF session and 4.23 g to 6.12 g/day in PD. Albumin losses were higher with postdilution HDF compared to HD. Total protein losses were not reported in HD studies. Daily protein losses in PD ranged from 4.37 ± 1.71 g to 10.0 ± 0.6 g. No studies in home HD or nocturnal HD populations were identified.

Conclusion: Amino acid/protein losses differ between HD/HDF and PD. Since PD occurs daily, patients receiving PD have greater weekly amino acid/protein losses than HD. Whether individualized replacement of these losses is linked to better clinical outcomes needs to be further explored.

接受维持性透析的成人患者的氨基酸和蛋白质损失:文献综述。
本综述旨在提供维持性血液透析/血液滤过(HD/HDF)、腹膜透析(PD)、家庭HD (HHD)和夜间HD (NHD)中氨基酸/蛋白质损失的最新进展。从2000年到2024年,所有测量透析液流出物中氨基酸、肽/蛋白质损失的记录都被包括在内。确定了29个符合条件的记录(14 HD/15 PD)。氨基酸损失范围为每4小时HD组9.3±2.9g至12.0±2.0g, PD组0.314g至0.522g/d。白蛋白损失范围为每HD/HDF期0.448g至3.99g, PD期4.23g至6.12g/天。与HD相比,稀释后HDF的白蛋白损失更高。HD研究中未报告总蛋白损失。PD患者每日蛋白质损失范围为4.37±1.71g至10.0±0.6g。未发现HHD或NHD人群的研究。氨基酸/蛋白质损失在HD/HDF和PD之间有所不同。由于PD每天都发生,接受PD的患者比HD患者每周的氨基酸/蛋白质损失更大。是否个体化替代这些损失与更好的临床结果有关需要进一步探讨。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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