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Effectiveness and nutritional consequences of amino acid-based vs glucose-based dialysis solutions in infants and children receiving CAPD.

Abstract
Excessive glucose absorption and dialysate amino acid and protein losses contribute to malnutrition in children on glucose-based continuous ambulatory peritoneal dialysis (CAPD). We used 2.5 and 4.25% glucose and 1.1 and 2.0% amino acid dialysates to assess short-term effectiveness and nutritional consequences of amino acid-based dialysis solutions. Plasma and effluent urea and creatinine concentrations were similar with amino acid and glucose dialysis although 16% less fluid was removed with amino acid dialysates. Absorption of 77.3 +/- 5.3% of dialysate amino acids exceeded losses of amino acids and protein in glucose effluent. With amino acid dialysates, fasting plasma glucose concentrations were maintained while plasma amino acid levels rose, peaked at 1 h, and, excepting methionine, isoleucine, and phenylalanine with the 2.0% solution, returned to initial levels after 5 h. Compared with glucose, amino acid dialysates provide reduced but satisfactory fluid and waste removal, maintain normoglycemia, and more than compensate for effluent losses of amino acids and protein.
AuthorsR M Hanning, J W Balfe, S H Zlotkin
JournalThe American journal of clinical nutrition (Am J Clin Nutr) Vol. 46 Issue 1 Pg. 22-30 (Jul 1987) ISSN: 0002-9165 [Print] United States
PMID3300250 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Amino Acids
  • Blood Glucose
  • Blood Proteins
  • Insulin
  • Solutions
  • Creatinine
  • Glucose
Topics
  • Amino Acids (administration & dosage, blood)
  • Blood Glucose (metabolism)
  • Blood Proteins (metabolism)
  • Child
  • Child Nutritional Physiological Phenomena
  • Child, Preschool
  • Creatinine (blood)
  • Glucose (administration & dosage)
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Insulin (blood)
  • Kidney Failure, Chronic (therapy)
  • Male
  • Osmolar Concentration
  • Peritoneal Dialysis, Continuous Ambulatory
  • Solutions

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