Amino acid and protein losses in adult patients receiving maintenance dialysis: a literature review
Mafrici, Bruno Viramontes-Hörner, Daniela Gardner, David S Smith, Kenneth Taal, Maarten W Selby, Nicholas M Hall, Matt
Mafrici, Bruno
Viramontes-Hörner, Daniela
Gardner, David S
Smith, Kenneth
Taal, Maarten W
Selby, Nicholas M
Hall, Matt
Abstract
BACKGROUND: A comprehensive, scoping review was initiated with the aim of providing an update regarding amino acid/protein losses in maintenance hemodialysis/hemodiafiltration (HD/HDF), peritoneal dialysis (PD), home HD (HHD), and nocturnal HD (NHD).
METHODS: From 2000 to 2024, all records that measured amino acid and peptide/protein losses in the dialysate effluent were included.
RESULTS: Twenty-nine eligible records were identified (14 HD/15 PD). Amino acid losses ranged from 9.3 ± 2.9 g to 12.0 ± 2.0 g per 4-hour HD session and 0.314 g to 0.522 g/day in PD. Albumin losses ranged from 0.448 g to 3.99 g per HD/HDF session and 4.23 g to 6.12 g/day in PD. Albumin losses were higher with postdilution HDF compared to HD. Total protein losses were not reported in HD studies. Daily protein losses in PD ranged from 4.37 ± 1.71 g to 10.0 ± 0.6 g. No studies in home HD or nocturnal HD populations were identified.
CONCLUSION: Amino acid/protein losses differ between HD/HDF and PD. Since PD occurs daily, patients receiving PD have greater weekly amino acid/protein losses than HD. Whether individualized replacement of these losses is linked to better clinical outcomes needs to be further explored.
MIDER Authors
Affiliations
Date
2025-08-07
Type
Article
Subject
Collections
Citation
Mafrici B, Viramontes-Hörner D, Gardner DS, Smith K, Taal MW, Selby NM, Hall M. Amino Acid and Protein Losses in Adult Patients Receiving Maintenance Dialysis: A Literature Review. J Ren Nutr. 2026 Jan;36(1):30-48. doi: 10.1053/j.jrn.2025.07.012