Journal of the American Society of Nephrology · 1997 · 225 citations · 4 references
MedicineBiochemistryNephrologyDialysisHemodialysisRenal Replacement TherapyAcid-base BalanceAmino Acid MetabolismChronic Kidney DiseaseDialysis NutritionRenal DiseaseRenal ImpairmentChronic Renal InsufficiencyDialysate PhLeucine MetabolismMetabolic Acidosis CorrectionProtein Degradation RateProtein Turnover AnalysisWhole-body Protein DegradationWhole-body Protein Turnover
Correction of acidosis in hemodialysis (HD) decreases protein degradation. The effect of the correction of chronic metabolic acidosis in chronic renal failure patients treated with HD was determined from the kinetics of infused L-[1-(13)C]leucine. Six HD patients were studied before (acid) and after (bicarbonate) correction of acidosis (pH: acid 7.36 +/- 0.01, bicarbonate 7.40 +/- 0.01, P < 0.005). Leucine appearance from body protein (PD) and leucine disappearance into body protein (PS) decreased significantly with correction of acidosis (PD: acid 180.6 +/- 7.3, bicarbonate 130.9 +/- 7.2 mumol.kg-1.h-1, P < 0.005; PS: acid 172.3 +/- 6.8, bicarbonate 122.0 +/- 6.8 mumol.kg-1.h-1, P < 0.005). There was no significant change in leucine oxidation or plasma amino acid concentrations. These results demonstrate that optimal correction of acidosis in HD is beneficial in terms of protein turnover and may improve long-term nutritional status in HD.
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