Loss of Amino Acids Into Dialysate During Hemodialysis Using Hydrophilic and Nonhydrophilic Polyester-Polymer Alloy and Polyacrylonitrile Membrane Dialyzers

摘要

During hemodialysis, amino acid loss through the dialysate remained a significant problem and was not clear in some dialyzers; therefore, we investigated amino acid loss with hydrophilic and nonhydrophilic polyester-polymer alloy membranes and polyacrylonitrile membranes. Nine maintenance hemodialysis patients were studied to assess amino acid loss during hemodialysis with the three membranes. Total amino acid losses were 85.7±27.2mg/L, 83.3±16.1mg/L, and 72.1±22.5mg/L with the hydrophilic, nonhydrophilic polyester-polymer alloy, and polyacrylonitrile membranes, respectively. Amino acid losses were greater with the hydrophilic membrane compared with the polyacrylonitrile membrane for ornithine (2.0±0.6 vs. 1.4±0.4mg/L, P=0.025), phenylalanine (2.4±0.9 vs. 1.8±0.8mg/L, P=0.012), and tryptophan (0.6±0.2 vs. 0.4±0.2mg/L, P=0.023). Amino acid losses were greater with the nonhydrophilic membrane than with the polyacrylonitrile membrane for ornithine (2.0±0.4 vs. 1.4±0.4mg/L, P=0.017), phenylalanine (2.3±0.5 vs. 1.8±0.8mg/L, P=0.018), tryptophan (0.7±0.2 vs. 0.4±0.2mg/L, P=0.003), and cystine (3.2±0.7 vs. 2.0±0.7mg/L, P=0.005). In conclusion, greater losses of ornithine, phenylalanine, tryptophan, and cystine were observed with polyester-polymer alloy than with polyacrylonitrile membranes during hemodialysis. Constant attention should be paid to the amino acid loss profile to improve nutritional control in hemodialysis patients.