Korean J Med.  2002 May;62(5):522-529.

Nutritional status and plasma amino acid profile in maintenance hemodialysis patients

• Youn DJ
• Kim JK
• Choi SJ
• Choi TY
• Hwang SD

Abstract

BACKGROUND
Many studies document the presence of abnormalities in amino acids metabolism in chronic uremia. These abnormalities have been attributed to low protein intake, deficiency of excretory and metabolic functions of the diseased kidneys, toxic effects of uremia on the intermediary metabolism of amino acids and in dialysis patients, loss of protein and amino acids by the dialytic procedure.
METHODS
This study was designed to compare anthropometric measurement, biochemical characteristics and plasma amino acid concentration between patients with end stage renal disease on maintenance hemodialysis (HD) and normal controls. A cross sectional study of overnight fasting plasma amino acids and plasma albumin, prealbumin, triglyceride (TG), cholesterol, transferrin concentration were performed on 20 hemodialysis patients and 20 normal controls, matched by age and sex.
RESULTS
The concentrations of prealbumin (25.60+/-7.05 mg/dL vs 35.08+/-8.11 mg/dL, p<0.005), transferrin (158.30+/-39.66 mg/dL vs 275.50+/-55.46 mg/dL, p<0.001) were found to be lower in HD patients. No differences in albumin, cholesterol and TG were observed between the two groups. Several amino acids (taurine, cystine, phosphoserine) were found to be higher in the HD patients, while the concentrations of other five amino acids (serine, alanine, valine, leucine, tyrosine) were lowered in HD patients. No differences in nine amino acids (asparagine, glutamine, proline, glycine, methionine, isoleucine, lysine, histidine, arginine) were observed between the two groups.
CONCLUSION
Our results suggest that chronic renal failure patients have malnutrition and amino acids abnormalities. To correct the amino acids abnormalities and improve nitrogen utilization in hemodialysis patients, correction of acidosis and supplementation of the diet with serine should be considered.

Keyword

Nutrition; Dialysis; Amino acids

MeSH Terms

Acidosis
Alanine
Amino Acids
Cholesterol
Cystine
Dialysis
Diet
Fasting
Glutamine
Glycine
Histidine
Humans
Isoleucine
Kidney
Kidney Failure, Chronic
Leucine
Lysine
Malnutrition
Metabolism
Methionine
Nitrogen
Nutritional Status*
Plasma*
Prealbumin
Proline
Renal Dialysis*
Serine
Serum Albumin
Transferrin
Triglycerides
Uremia
Valine
Alanine
Amino Acids
Cholesterol
Cystine
Glutamine
Glycine
Histidine
Isoleucine
Leucine
Lysine
Methionine
Nitrogen
Prealbumin
Proline
Serine
Serum Albumin
Transferrin
Valine