Amino Acid Balance with Extended Daily Diafiltration in Acute Kidney Injury
Open accessAbstract
Background: The impact of hybrid dialysis therapies on amino acid (AA) balance in critically ill patients with acute kidney injury is unknown. Methods: We examined prospectively the AA balance with extended daily diafiltration (EDDF). Results: We studied 7 patients. AA clearances with EDDF ranged from 21.6 ml/min (tryptophan) to 66.9 ml/min (taurine). AA loss was 4.2 (IQR 1.4–12.3) g/day and 4.5% of daily protein intake for patients on enteral nutrition (EN). Percentage AA loss per hour on EDDF was highest for glutamine (32.1%) and lowest for glutamic acid (0.8%). Blood AA levels correlated with corresponding EDDF losses. Median total nitrogen appearance was 25.0 (IQR 20.6–29.3) g/day for patients on EN. This resulted in a negative nitrogen balance of –10.7 (IQR –16.6 to –1.4) g/day, of which 6.5% was attributable to AA loss. Conclusions: AA loss with EDDF was limited, but with much individual variability, and contributed to a strongly negative daily nitrogen balance.
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Enteral GLN has also proven to improve body composition and in particular lean body mass in a group of 44 head and neck cancer patients randomized to receive a GLN supplement (30 g daily) for four weeks.
“Finally, enteral GLN has also proven to improve body composition and in particular lean body mass in a group of 44 head and neck cancer patients randomized to receive a GLN supplement (30 g daily) for four weeks (220).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [220]
The authors observed a significant improvement of fat-free mass, serum albumin, and quality of life scores postoperatively.
“The authors observed a significant Improvement of fat-free mass, serum albumin, and quality of life scores postoperatively (220).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [220]
Cites
Bellomo, R., Ronco, C., Kellum, J. A., Mehta, R. L., Palevsky, P. M., & workgroup, T. A. (2004) · Critical Care · doi:10.1186/cc2872 · Cited by 6,769 · see citing works
Self-citationTHE MICRO-KJELDAHL DETERMINATION OF THE NITROGEN CONTENT OF AMINO ACIDS AND PROTEINS
Miller, L., & Houghton, J. A. (1945) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(19)52798-3 · Cited by 251 · see citing works
Amino acid losses during hemodialysis with infusion of amino acids and glucose
Wolfson, M., Jones, M. R., & Kopple, J. D. (1982) · Kidney International · doi:10.1038/ki.1982.52 · Cited by 243 · see citing works
Prevalence and Clinical Outcome Associated with Preexisting Malnutrition in Acute Renal Failure
Fiaccadori, E., Lombardi, M., Leonardi, S., Rotelli, C., Tortorella, G., & Borghetti, A. (1999) · Journal of the American Society of Nephrology · doi:10.1681/asn.v103581 · Cited by 232 · see citing works
Maxvold, N. J., Smoyer, W. E., Custer, J. R., & Bunchman, T. E. (2000) · Critical Care Medicine · doi:10.1097/00003246-200004000-00041 · Cited by 163 · see citing works
High Protein Intake during Continuous Hemodiafiltration: Impact on Amino Acids and Nitrogen Balance
Bellomo, R., Tan, H. K., Bhonagiri, D., Gopal, I., Seacombe, J., Daskalakis, M., & Boyce, N. (2002) · The International Journal of Artificial Organs · doi:10.1177/039139880202500403 · Cited by 129 · see citing works
Self-citationDAVIES, S. P., Reaveley, D. A., Brown, E. A., & Kox, W. J. (1991) · Critical Care Medicine · doi:10.1097/00003246-199112000-00012 · Cited by 104 · see citing works
Nutritional management of acute renal failure
Druml, W. (2005) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2004.09.012 · Cited by 100 · see citing works
Glutamine in critical care: current evidence from systematic reviews
Avenell, A. (2006) · Proceedings of The Nutrition Society · doi:10.1079/pns2006498 · Cited by 79 · see citing works
Btaiche, I. F., Mohammad, R. A., Alaniz, C., & Mueller, B. A. (2008) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.28.5.600 · Cited by 78 · see citing works
Amino acid losses during continuous high-flux hemofiltration in the critically ill patient
Davenport, A., & Roberts, N. B. (1989) · Critical Care Medicine · doi:10.1097/00003246-198910000-00009 · Cited by 71 · see citing works
Nutritional support in acute kidney injury
Fiaccadori, E., Parenti, E., & Maggiore, U. (2008) · Journal of Nephrology · doi:10.1093/joneph/21.5.645 · Cited by 63 · see citing works
Protein Metabolism in Acute Renal Failure
Druml, W. (1997) · Mineral and Electrolyte Metabolism · doi:10.1159/000057350 · Cited by 60 · see citing works
Berg, A., Norberg, Å., Martling, C., Gamrin, L., Rooyackers, O., & Wernerman, J. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0547-9 · Cited by 57 · see citing works
Baldwin, I. T., Naka, T., Koch, B., Fealy, N., & Bellomo, R. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0596-0 · Cited by 55 · see citing works
Self-citationBaldwin, I., Bellomo, R., Naka, T., Koch, B., & Fealy, N. (2007) · The International Journal of Artificial Organs · doi:10.1177/039139880703001208 · Cited by 53 · see citing works
Self-citationUhe, A. M., Collier, G. R., McLennan, E. A., Tucker, D. J., & O’Dea, K. (1991) · Journal of Chromatography B Biomedical Sciences and Applications · doi:10.1016/0378-4347(91)80071-j · Cited by 51 · see citing works
Hynote, E. D., Mccamish, M. A., Depner, T. A., & Davis, P. A. (1995) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/014860719501900115 · Cited by 43 · see citing works
Glutamine and Other Amino Acid Losses During Continuous Venovenous Hemodiafiltration
Novák, I., Šrámek, V., Pittrová, H., Rušavý, Z., Těšínský, P., Lacigová, S., Eiselt, M., Kohoutková, L., Veselá, E., & Opatrný, K., Jr. (1997) · Artificial Organs · doi:10.1111/j.1525-1594.1997.tb00731.x · Cited by 29 · see citing works
Kihara, M., Ikeda, Y., Fujita, H., Miura, M., Masumori, S., Tamura, K., Yabana, M., Takagi, N., Umemura, S., & Ishii, M. (1997) · Intensive Care Medicine · doi:10.1007/s001340050299 · Cited by 21 · see citing works
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ESPEN guideline on clinical nutrition in the intensive care unit.
Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.037 · Cited by 2,904 · see citing works
ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease
Fiaccadori, E., Sabatino, A., Barazzoni, R., Carrero, J. J., Cupisti, A., De Waele, E., Jonckheer, J., Singer, P., & Cuerda, C. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.01.028 · Cited by 277 · see citing works
Proteins and amino acids are fundamental to optimal nutrition support in critically ill patients
Weijs, P. J. M., Cynober, L., DeLegge, M. H., Kreymann, G., Wernerman, J., & Wolfe, R. R. (2014) · Critical Care · doi:10.1186/s13054-014-0591-0 · Cited by 102 · see citing works
Timing of renal replacement therapy initiation for acute kidney injury
Fayad, A., Buamscha, D. G., & Ciapponi, A. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010612.pub2 · Cited by 58 · see citing works
Micronutrient and Amino Acid Losses During Renal Replacement Therapy for Acute Kidney Injury
Oh, W. C., Mafrici, B., Rigby, M., Harvey, D., Sharman, A., Allen, J., Mahajan, R. P., Gardner, D. S., & Devonald, M. A. J. (2019) · Kidney International Reports · doi:10.1016/j.ekir.2019.05.001 · Cited by 52 · see citing works
Extended Mortality and Chronic Kidney Disease After Septic Acute Kidney Injury
Chua, H., Wong, W. K., Ong, V., Agrawal, D., Vathsala, A., Tay, H. M., & Mukhopadhyay, A. (2018) · Journal of Intensive Care Medicine · doi:10.1177/0885066618764617 · Cited by 51 · see citing works
Self-citationIntensive Care Unit–Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review
Teixeira, J. P., Mayer, K. P., Griffin, B. R., George, N. R., Jenkins, N. D. M., Pal, C. A., González-Seguel, F., & Neyra, J. A. (2022) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2022.08.028 · Cited by 45 · see citing works
Sabatino, A., Fiaccadori, E., Barazzoni, R., Carrero, J. J., Cupisti, A., De Waele, E., Jonckheer, J., Cuerda, C., & Bischoff, S. C. (2024) · Clinical Nutrition · doi:10.1016/j.clnu.2024.08.002 · Cited by 40 · see citing works
Bellomo, R., Cass, A., Cole, L., Finfer, S. R., Gallagher, M., Lee, J., Lo, S., McArthur, C. J., McGuinness, S., Norton, R., et al. (2014) · Blood Purification · doi:10.1159/000363175 · Cited by 34 · see citing works
Self-citationTiming of kidney replacement therapy initiation for acute kidney injury
Fayad, A., Buamscha, D. G., & Ciapponi, A. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010612.pub3 · Cited by 32 · see citing works
Protein metabolism and requirements in the ICU
Singer, P. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.03.026 · Cited by 28 · see citing works
Paats, J., Adoberg, A., Arund, J., Dhondt, A., Fernström, A., Fridolin, I., Glorieux, G., Leis, L., Luman, M., González‐Parra, E., et al. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21041522 · Cited by 27 · see citing works
Amino Acid Loss during Continuous Venovenous Hemofiltration in Critically Ill Patients
Stapel, S. N., de Boer, R. J., Thoral, P. J., Vervloet, M. G., Girbes, A. R. J., & Straaten, H. M. O. (2019) · Blood Purification · doi:10.1159/000500998 · Cited by 26 · see citing works
Tsujimoto, Y., Miki, S., Shimada, H., Tsujimoto, H., Yasuda, H., Kataoka, Y., & Fujii, T. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013330.pub2 · Cited by 24 · see citing works
Low caloric and protein intake is associated with mortality in patients with acute kidney injury
Bufarah, M. N. B., Costa, N. A., Losilla, M. P. R., Reis, N. S. D. C., Silva, M. Z. C., Balbi, A. L., & Ponce, D. (2018) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2018.01.012 · Cited by 23 · see citing works
Schmidt, J. J., Hafer, C., Spielmann, J., Hadem, J., Schönenberger, E., Schmidt, B. M. W., & Kielstein, J. T. (2014) · Nephron Clinical Practice · doi:10.1159/000358434 · Cited by 17 · see citing works
Bufarah, M. N. B., de Góes, C. R., de Oliveira, M. C., Ponce, D., & Balbi, A. L. (2016) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2016.09.002 · Cited by 12 · see citing works
Protein Delivery in Critical Care- What Have Recent Trials Shown Us?
Paulus, M. C., & van Zanten, A. R. H. (2024) · Critical Care Clinics · doi:10.1016/j.ccc.2024.09.003 · Cited by 9 · see citing works
Mario, F. D., Sabatino, A., & Fiaccadori, E. (2024) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2024.12.015 · Cited by 9 · see citing works
Napoli, M., Gianfreda, D., Matino, S., Ria, P., Zito, A., Fontò, G., Barbarini, S., & Pascalis, A. D. (2025) · Journal of Nephrology · doi:10.1007/s40620-024-02142-z · Cited by 5 · see citing works
Wu, B., Ji, D., Xu, B., Fan, R., & Gong, D. (2019) · Hemodialysis International · doi:10.1111/hdi.12709 · Cited by 4 · see citing works
Straaten, H. M. O., Chua, H., Joannès-Boyau, O., & Bellomo, R. (2015) · Springer eBooks · doi:10.1007/978-3-319-17389-4_16 · Cited by 3 · see citing works
Self-citationAmino Acid Turnover, Protein Metabolism, and Nitrogen Balance in Acute Kidney Injury
Chua, H., & Puthucheary, Z. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-44942-7.00074-1 · Cited by 3 · see citing works
Self-citationChen, Y., Ren, J., Qin, X., Li, G., Zhou, B., Gu, G., Hong, Z., Aa, J., & Li, J. (2015) · BioMed Research International · doi:10.1155/2015/917674 · Cited by 2 · see citing works
Reduced Glutamatergic Neurotransmission as Possible Indicator of Unfavorable Prognosis
Alekseeva, E. (2017) · International Journal of Biomedicine · doi:10.21103/article7(1)_ra2 · Cited by 1 · see citing works
Druml, W. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-44942-7.00073-x
Normal physiology of nutrition
Blaser, A. R., & Deane, A. M. (2016) · doi:10.1093/med/9780199600830.003.0201
Jonny, J., Larasati, A. D., Ramadhani, B. P., Hernowo, B. A., & Pasiak, T. F. (2024) · Emergency and Critical Care Medicine · doi:10.1097/ec9.0000000000000123
Nutrition in Sepsis, AKI, and CRRT
Premuzic, V., & Atić, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-66541-7_22
Elusive guidance to dosing of protein in critical illness
McClave, S. A., Miller, K. R., & Martindale, R. G. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001281
Critical care nutrition and the legacy of Rinaldo Bellomo
Deane, A. M., Peake, S., Davies, A. R., Abdelhamid, Y. A., Egi, M., Chapman, M. J., & Ridley, E. J. (2025) · Critical Care and Resuscitation · doi:10.1016/j.ccrj.2025.100147
Bufarah, M. N. B. (2014) · Americanae (AECID Library)
- Authors
- Chua, H. R., Baldwin, I., Fealy, N., Naka, T., & Bellomo, R.
- Affiliations
- Austin Hospital (AU)
- Venue
- Blood Purification
- Publisher
- S. Karger AG
- Published
- 2012
- Volume
- 33
- Issue
- 4
- Pages
- 292-299
- ISSN
- 0253-5068 (ISSN-L)
- 1421-9735
- OpenAlex
- W2022065329
- Cited by
- 32
- References
- 20
- Citations by year
- 2025: 3 · 2024: 5 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 5 · 2018: 4 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 4
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Blood Purification (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- amino acid balance, acute kidney injury, amino acid loss, nitrogen balance, enteral nutrition, critically ill patients, glutamine, taurine, tryptophan, blood amino acid levels
- MeSH terms
- Adult, Aged, Aged, 80 and over, Amino Acids, Enteral Nutrition, Female, Renal Dialysis, Humans, Male, Middle Aged, Nitrogen, Dialysis Solutions, Critical Illness, Acute Kidney Injury
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