Fukushima journal of medical science · 2026
Elevation of non-esterified fatty acids induced by hemodialysis sessions : pathophysiology and management strategies.
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Fujiwara Masako, Terawaki Hiroyuki, Ando Itiro, Shishido You, Ito Takafumi
Аннотация
BACKGROUND: Although increases in plasma levels of non-esterified fatty acids (NEFA) during hemodialysis (HD) have been reported, the precise time course of this elevation, its underlying pathophysiology, and effective therapeutic strategies remain unclear.
METHODS: The time course of plasma NEFA and immunoreactive insulin (IRI) concentrations during HD sessions was examined in seven patients with end-stage kidney disease across three phases : no intervention (control phase), intradialytic parenteral nutrition with an amino acid solution (IVAA phase), and intradialytic parenteral nutrition with amino acid and glucose solutions (IVAA + IVG phase).
RESULTS: Plasma NEFA concentrations, which increased beyond the normal range during the control and IVAA phases, remained within normal limits in the IVAA + IVG phase, likely due to the maintenance of plasma IRI concentrations above the fasting range.
CONCLUSION: Hemodialysis elevated plasma NEFA concentrations to abnormally high levels, but this increase was suppressed by intradialytic parenteral nutrition containing amino acids and glucose.
METHODS: The time course of plasma NEFA and immunoreactive insulin (IRI) concentrations during HD sessions was examined in seven patients with end-stage kidney disease across three phases : no intervention (control phase), intradialytic parenteral nutrition with an amino acid solution (IVAA phase), and intradialytic parenteral nutrition with amino acid and glucose solutions (IVAA + IVG phase).
RESULTS: Plasma NEFA concentrations, which increased beyond the normal range during the control and IVAA phases, remained within normal limits in the IVAA + IVG phase, likely due to the maintenance of plasma IRI concentrations above the fasting range.
CONCLUSION: Hemodialysis elevated plasma NEFA concentrations to abnormally high levels, but this increase was suppressed by intradialytic parenteral nutrition containing amino acids and glucose.