Treatment of malnutrition with 1.1% amino acid peritoneal dialysis solution: Results of a multicenter outpatient study

Jones, Michael R.; T, Hagen; Boyle, CA; Vonesh, Edward F.; Hamburger, Richard J.; Charytan, Chaim; Sandroni, Stephen; Bernard, David B.; Piraino, Beth; Schreiber, M; Gehr, Todd W.B.; Fein, Paul A.; Friedlander, Miriam A.; Burkart, John M.; Ross, Daniel W.; Zimmerman, S. W.; Swartz, Richard D.; Knight, Tyler; Kraus, Alfred; McDonald, Lauren; Hartnett, Michael N.; Weaver, M. Libby; Martis, Leo; Moran, John

doi:10.1016/s0272-6386(98)70131-3

Cited by 158 publications

(115 citation statements)

References 29 publications

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“…This is in line with an effective utilization of the intraperitoneally administered AA. We also found a decrease in serum phosphate levels, suggesting a shift of phosphate toward the intracellular space, which is another indication that AAG dialysis induced an anabolic response (11,17). With the use of the AAG, serum bicarbonate levels were slightly lower than on G dialysis but remained within the normal range.…”

Section: Discussionmentioning

confidence: 51%

“…In continuous ambulatory PD (CAPD) patients, amino acid (AA)-containing dialysate has been used to compensate for a low dietary protein intake and loss of AA and proteins through peritoneal clearance (10). Until now, however, no convincing clinical benefits have been demonstrated (11)(12)(13)(14)(15)(16)(17)(18)(19). AA dialysate may lead to significant increase in serum urea levels (11)(12)(13)(14) and metabolic acidosis (11,12,15), a protein catabolic stimulus (20,21).…”

mentioning

confidence: 99%

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Dialysate as Food

Tjiong¹,

Berg²,

Wattimena³

et al. 2005

Journal of the American Society of Nephrology

103

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Section: Discussionmentioning

confidence: 51%

mentioning

confidence: 99%

Dialysate as Food

Tjiong¹,

Berg²,

Wattimena³

et al. 2005

Journal of the American Society of Nephrology

103

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“…The high cost of IDPN and regulatory concerns remain the greatest barriers for use of IDPN, which should be reserved for patients in whom oral or enteral supplements are not feasible. Other studies using amino acids in dialysate (AAD) as a nutritional intervention in PD patients with PEW have provided conflicting results (58,59). Overall, AAD remains a viable option in PD patients with PEW who cannot tolerate or are not suitable for oral and other enteral supplements.…”

Section: Treatment Of Pew: An Integrated Approachmentioning

confidence: 99%

A Patient with CKD and Poor Nutritional Status

İkizler

2013

Clinical Journal of the American Society of Nephrology

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SummaryProtein energy wasting is common in patients with CKD and ESRD and is associated with adverse clinical outcomes, such as increased rates of hospitalization and death, in these patients. A multitude of factors can affect the nutritional and metabolic status of patients with CKD, including decreased dietary nutrient intake, catabolic effects of renal replacement therapy, systemic inflammation, metabolic and hormonal derangements, and comorbid conditions (such as diabetes and depression). Unique aspects of CKD also confound reliable assessment of nutritional status, further complicating management of this comorbid condition. In patients in whom preventive measures and oral dietary intake from regular meals cannot help them maintain adequate nutritional status, nutritional supplementation, administered orally, enterally, or parenterally, is effective in replenishing protein and energy stores. The advantages of oral nutritional supplements include proven efficacy, safety, and compliance. Anabolic steroids and exercise, with nutritional supplementation or alone, improve protein stores and represent potential additional approaches for the treatment of PEW. There are several emerging novel therapies, such as appetite stimulants, anti-inflammatory interventions, and anabolic agents.

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“…However, the use of amino-acid-based intraperitoneal solutions may be limited by adverse metabolic effects, such as metabolic acidosis, reduced ultrafiltration, uremia, and poor oral intake [46]. In an interventional study, where PD patients with insufficient dietary protein intake (1.0 g protein/kg/day or less) were treated with 1 or 2 bags of 2 L 1.1% AA solution exchanges, by Kopple et al found that serum urea levels of patients increased by about 30%, and patients developed mild metabolic acidosis, mainly those treated with 2 bags of AA solutions a day [47].…”

Section: Discussionmentioning

confidence: 99%