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Hemodialysis removes solutes uniformly according to their molecular weight. During each hemodialysis session, 6–8 g of amino acids are reportedly removed into the dialysate. Little is known about the amount of amino acids removed from those who have undergone intradialytic parenteral nutrition (IDPN). Objective: We measured amino acid amounts prospectively during hemodialysis treatment. Methods: We used 200 ml of 7.2% amino acid solution (KidminTM), 200 ml of 50% glucose, and 20% of lipid emulsion as IDPN fluid. Blood samples were collected at the beginning and end of each session. The dialysate portion was also collected. Results: Six patients were included in this study after providing written informed consent. The amount of amino acids removed during hemodialysis sessions was calculated as 9.1±1.4 g, which was less than that infused as IDPN. The profiles of the removed amino acids showed that the amount removed was less than that within IDPN. However, for tyrosine and alanine, hemodialysis treatment removed more amino acids than that infused as IDPN, as well as amino acids that were not IDPN solution constituents. During a 2-week follow-up period, no significant change in amino acid profiles was observed. Conclusions: IDPN entirely supplemented the removed amino acids, although some amino acids were not restored.

Better nutritional status and early initiation of dialysis had been considered one of the most important methods for better prognosis of dialysis patients. In this study, we analyzed the effects of nutritional status, renal function at the start of renal replacement therapy (RRT), and co morbidity on 12-month survival of ESRD patients. The subjects in this study were 9695 new ESRD patients who started RRT in 2007 in Japan. The average age of the subjects was 67.5 years, 64.1% of the subjects were male, and 42.9% had diabetes. During the 12-month period after the start of RRT, 1546 patients died, and 35 patients received renal transplantation. Average estimated glomerular filtration rate (eGFR) at the initiation of dialysis was 6.52+ 4.20 mL/min/1.73 m2. Average serum albumin was significantly higher (P