| Abstract [eng] |
Aim. To establish a connection between homeostasis of amino acids and metabolism in critically ill patients on renal replacement therapy. Materials and methods. Critically ill patients on renal replacement therapy and mechanical lung ventilation were included in this prospective study. Energy expenditure was measured using indirect calorimetry. Calorimetric assay was used to determine amino acid concentrations. Results. 60 patients were included in the study, mean age 66 ± 12.91 years, mean SOFA score value 12.25 ± 3.61. Mean energy expenditure was 1579 ± 517 kcal/day, a correlation was found between energy expenditure and basal metabolic rate, calculated with Harris-Benedict equation (R = 0.584, Beta = 0.854, p < 0.001). Mean amino acid concentration in systemic circulation was 1.84 [1.38-2.98] mmol/L, amount of lost amino acids - 11.79 [7.27-20.14] g. A correlation was found between amino acid concentration in the circulation and the amount of lost amino acids (R = 0.686, Beta = 0.686, p < 0.001). When patients were distributed into two groups (energy expenditure < 50 percentile and > 50 percentile), there was a statistically significant difference of amino acid concentration in the circulation between groups (1.66 [1.3 – 2.225] mmol/l vs. 2.59 [1.44 – 3.28] mmol/l, p = 0.029). Conclusions. There was a substantial loss of amino acids seen in the study, as well as a connection between amino acid concentration in systemic circulation and their loss during renal replacement therapy. Higher concentrations of amino acids in systemic circulation were seen in patients with higher energy expenditure. |
