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首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Effects of amino acid dialysis compared to dextrose dialysis in children on continuous cycling peritoneal dialysis.
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Effects of amino acid dialysis compared to dextrose dialysis in children on continuous cycling peritoneal dialysis.

机译：小儿氨基酸透析与右旋糖透析相比对连续循环腹膜透析的影响。

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摘要

OBJECTIVE: To compare the biochemical and nutritional effects of amino acid dialysis with dextrose dialysis in children receiving continuous cycling peritoneal dialysis (CCPD). DESIGN: A prospective randomized cross-over study. SETTING: Nonhospitalized patients. PATIENTS: Seven children aged 1.8 to 16.0 years (mean 8.1 years) with end-stage renal disease who were receiving CCPD. INTERVENTIONS: Each patient received nighttime automated CCPD of dextrose, plus a single daytime dwell of either amino acid dialysate or dextrose dialysate. After 3 months, subjects crossed over to the alternative regimen for a subsequent 3 months. MAIN OUTCOME MEASURES: Creatinine clearance, ultrafiltration, urea, creatinine, electrolytes, total protein, albumin, fasting plasma amino acids, anthropometrics, total body nitrogen. RESULTS: Amino acid dialysis was comparable to dextrose dialysis for creatinine clearance and ultrafiltration. Plasma urea concentrations were higher during amino acid dialysis. No clinical side effects or worsening of metabolic acidosis was observed. Caloric intake increased and protein intake improved. Appetite and total body nitrogen increased in at least half the children during amino acid dialysis.Total plasma protein and albumin concentrations did not change significantly. Fasting plasma concentrations of amino acids after 3 months of amino acid dialysis were comparable to baseline values. For several amino acids, the dose-response curve was blunted after a single amino acid exchange following 3 months of amino acid dialysis, which may, in part, be due to the induction of hepatic enzyme synthesis. CONCLUSIONS: Amino acid dialysis is an efficient form of peritoneal dialysis that should be considered for children with poor nutritional status for whom enteral nutrition supplementation has been unsuccessful. Further study is needed to determine the optimal amount of amino acids to deliver, the best time to administer the amino acid dialysis fluid, and the benefits of adding dextrose to the amino acid solution.
机译：目的：比较氨基酸透析和右旋糖透析对接受连续循环腹膜透析（CCPD）的儿童的生化和营养作用。设计：一项前瞻性随机交叉研究。地点：非住院患者。患者：接受CCPD的7名年龄在1.8至16.0岁（平均8.1岁）的患有终末期肾脏疾病的儿童。干预措施：每位患者在夜间接受葡萄糖的自动CCPD监测，并在白天进行一次氨基酸透析液或葡萄糖透析液的住院治疗。 3个月后，受试者在接下来的3个月内越过替代方案。主要观察指标：肌酐清除率，超滤，尿素，肌酐，电解质，总蛋白，白蛋白，空腹血浆氨基酸，人体测量学，人体总氮。结果：氨基酸透析在肌酐清除率和超滤方面可与葡萄糖透析媲美。氨基酸透析期间血浆尿素浓度较高。没有观察到临床副作用或代谢性酸中毒的恶化。热量摄入增加，蛋白质摄入增加。氨基酸透析期间至少有一半的儿童食欲和总氮增加，血浆总蛋白和白蛋白浓度无明显变化。氨基酸透析3个月后的空腹血浆氨基酸浓度与基线值相当。对于几种氨基酸，在氨基酸透析3个月后进行一次氨基酸交换后，剂量反应曲线变钝，这可能部分是由于肝酶合成的诱导。结论：氨基酸透析是腹膜透析的一种有效形式，对于营养状况不佳的儿童（肠内营养补充未能成功）应考虑使用。需要进行进一步的研究以确定最佳的氨基酸输送量，最佳的时间来施用氨基酸透析液，以及将葡萄糖添加到氨基酸溶液中的好处。

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