title: Branched-chain amino acid in chronic renal failure patients: respiratory and sleep effects.
abstract: Sleep disorders, including a high incidence of sleep apnea, have been recognized as a significant problem in chronic renal failure (CRF) patients. In a preliminary study, we examined CRF patients on maintenance hemodialysis for three nights; one control night, and thereafter randomized to infusion of saline (placebo) for one night and 4% branch-chain amino acid (BCAA) solution for one night. Polysomnographic and respiratory data [respiratory rate, oxygen saturation and end-tidal CO2 (ETCO2)] was recorded continuously throughout the nights and data from each hour compared with baseline (awake) values. The patients studied were characterized by reduced sleep quality and decreased amount of rapid eye movement (REM) sleep. The BCAA infusion was associated with a return of REM sleep to normal and a significant decrease in ETCO2 during both REM and non-REM sleep (P less than 0.05). Our findings demonstrate respiratory stimulation during sleep with infusion of BCAA; this stimulatory effect on respiration (in contrast to many respiratory stimulants) is associated with an increased amount of REM sleep.
authors.affiliation: Department of Anesthesiology, Baumritter Kidney Center, Bronx, New York.
authors.forename: E
authors.initials: E
authors.lastname: Söreide
authors.forename: B
authors.initials: B
authors.lastname: Skeie
authors.forename: O
authors.initials: O
authors.lastname: Kirvelä
authors.forename: R
authors.initials: R
authors.lastname: Lynn
authors.forename: N
authors.initials: N
authors.lastname: Ginsberg
authors.forename: T
authors.initials: T
authors.lastname: Manner
authors.forename: D P
authors.initials: DP
authors.lastname: Katz
authors.forename: J
authors.initials: J
authors.lastname: Askanazi
mesh_terms: D000328:Adult; D000597:Amino Acids, Branched-Chain / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012119:Respiration / Q000187:drug effects* / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D012894:Sleep Stages / Q000187:drug effects; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000209:etiology; D013268:Stimulation, Chemical
chemical_list: D000597:Amino Acids, Branched-Chain