The pattern of intracellular free amino acids in granulocytes from hemodialysis patients change to an oral protein supplement (granulocyte amino acids after protein in HD patients).
METHODS
The concentrations of free intracellular amino acids in granulocytes and plasma amino acids, normalized protein nitrogen appearance rate, serum insulin-like growth factors, plasma proteins, anthropometric and bioimpedance measurements were determined before and after an oral protein supplement in 19 stable patients on maintenance hemodialysis in a randomized, double-blind placebo-controlled study with crossover after 3 months. The hemodialysis patients were well-nourished with an ideal body weight of 91% after both protein supplementation and after placebo.


RESULTS
After protein supplementation (7.8 g/d) the intracellular concentration of valine, isoleucine, threonine and tyrosine and the valine/glycine and tyrosine/phenylalanine ratios in the cells were significantly increased (p < 0.05). In contrast, the concentrations of plasma amino acids, serum insulin-like growth factors, and plasma proteins and body weight and anthropometric and bioimpedance measurements were unchanged. Dialysis efficiency was unchanged throughout the study.


CONCLUSIONS
The present study supports the conclusion that protein supplementation to well-nourished hemodialysis patients does not improve the nutritional status measured by plasma proteins, body weight, anthropometric and bioimpedance measurements. The increase in intracellular amino acid concentrations indicates better cellular nutrition and metabolic control.
Ivarsen
P
P
Research Laboratory for Nephrology and Hypertension, Aarhus University Hospital, Denmark.
Frystyk
J
J
Pedersen
E B
EB
D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000032:analysis* / Q000097:blood; D000886:Anthropometry; D001798:Blood Proteins / Q000032:analysis; D018592:Cross-Over Studies; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D004311:Double-Blind Method; D017097:Electric Impedance; D005260:Female; D005998:Glycine / Q000032:analysis / Q000097:blood; D006098:Granulocytes / Q000378:metabolism*; D006801:Humans; D007532:Isoleucine / Q000032:analysis / Q000097:blood; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000032:analysis / Q000097:blood; D010649:Phenylalanine / Q000032:analysis / Q000097:blood; D010919:Placebos; D006435:Renal Dialysis; D013002:Somatomedins / Q000032:analysis; D013912:Threonine / Q000032:analysis / Q000097:blood; D014443:Tyrosine / Q000032:analysis / Q000097:blood; D014633:Valine / Q000032:analysis / Q000097:blood
D000596:Amino Acids; D001798:Blood Proteins; D004044:Dietary Proteins; D010919:Placebos; D013002:Somatomedins; D007532:Isoleucine; D013912:Threonine; D014443:Tyrosine; D010649:Phenylalanine; D014633:Valine; D009584:Nitrogen; D005998:Glycine