Benefit of Intravenous Essential Amino-Acids in Catabolic Patients on Chronic Maintenance Hemodialysis

Abstract

The effect on the clinical status of catabolic hemodialysis patients of I.V. essential amino-acids administered over 3 months at the end of each dialysis is assessed in an open clinical follow-up study of 10 patients; these patients showed a progressive deterioration of general condition and a progressive weight loss in the period before the start of the treatment. The study was undertaken in a hospital dialysis unit, with as main outcome measures body weight, hematocrit, a scoring index of general condition and degree of edema. In patients showing a progressive and consistent loss of body weight in the months preceding the study, after the first treatment month, body weight started to rise, increasing after 3 months from 56.2 +/- 2.3 to 58.6 +/- 2.4 kg (p less than 0.01). The hematocrit raised from 22.4 +/- 1.6% up to 26.5 +/- 1.9% (p less than 0.02). Over this period, only 2 liters of packed cells were administered, in contrast to an overall need of 13 liters in the preceding 6 months. Peripheral and/or pulmonary edema disappeared. A scoring index, of general condition, increased from 5.1 +/- 1.5 before the start of the study to 11.7 +/- 0.8 after 3 months (p less than 0.01). It is concluded that the parenteral administration of amino-acids in catabolic patients on chronic hemodialysis has a beneficial effect on general condition, and the balance of body fluid and body mass.

Can Nutritional Intervention Limit Protein Energy Wasting?

“…The difference in survival was limited to patients who did not have diabetes mellitus. Several other studies have also observed improvement in various nutritional parameters like body weight or albumin when IDPN was prescribed (26–32).…”