Administration of a branched-chain amino acid preparation during hepatic failure: a study emphasizing ammonia metabolism.
We administered a branched-chain amino acid (BCAA) infusion to 16 patients with hepatic failure and two healthy subjects, and then evaluated its effects on ammonia metabolism and amino acid metabolic pool. Immediately after the BCAA infusion, the venous blood ammonia concentration increased in 12 of 15 patients with hepatic failure and in both two healthy subjects. Glutamine (Gln) also rose in all cases following the BCAA infusion, and this rise was particularly marked in the hepatic failure group. The increase in Gln due to the BCAA infusion and the arteriovenous difference in the pre-administration ammonia concentration showed a good correlation. These results suggest an increase in glutamine cycle capacity in patients with hepatic failure.
Nishikawa
Y
Y
First Department of Internal Medicine, Okayama University Medical School, Japan.
Ukida
M
M
Matsuo
R
R
Morimoto
Y
Y
Omori
N
N
Mikami
M
M
Tsuji
T
T
D000328:Adult; D000368:Aged; D000409:Alanine / Q000097:blood; D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use*; D000641:Ammonia / Q000097:blood / Q000378:metabolism*; D001158:Arteries; D001806:Blood Urea Nitrogen; D005260:Female; D005740:Gases / Q000097:blood; D005973:Glutamine / Q000097:blood; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D014680:Veins
D000597:Amino Acids, Branched-Chain; D005740:Gases; D005973:Glutamine; D000641:Ammonia; D000409:Alanine