关键词: 维持性血液透析, 营养状态, 能量, 氨基酸

Abstract: Objective To investigate the effect of hypertonic glucose or amino acids infusion through the dialysis circuit on nutrition status, biochemical indexes and serum amino acids spectrum in maintenance hemodialysis (MHD) patients with malnutrition. Methods Thirty-two MHD patients consistent with the inclusion criteria and exclusion criteria were enrolled in this study. They were randomly divided into control group, glucose infusion group (50% glucose 250ml infusion in every dialysis session) and amino acids infusion group (8.5% amino acids 250ml infusion in every dialysis session). Nutrition status was estimated by using Subjective Global Assessment (SGA) method. Serum biochemical indexes were determined, and serum concentrations of the 22 amino acids were measured. Results Six months later SGA levels were similar with the baseline. Elevation of serum albumin and prealbumin compared with baseline levels were not found in three groups. The glucose infusion group had significantly increased levels for concentrations of essential amino acids (697.0 vs. 590.5nmol/L，P=0.032) wherease concentrations of essential amino acids in amino acid infusion group showed decreasing trend. Conclusion Hypertonic glucose infusion during dialysis may improve protein metabolism, suggesting that sufficient energy supply may be more important than nitrogen balance in MHD patients.