title: Correction of acidosis in hemodialysis decreases whole-body protein degradation.
abstract: 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.
authors.affiliation: Department of Medicine, University of Newcastle upon Tyne, United Kingdom.
authors.forename: K A
authors.initials: KA
authors.lastname: Graham
authors.forename: D
authors.initials: D
authors.lastname: Reaich
authors.forename: S M
authors.initials: SM
authors.lastname: Channon
authors.forename: S
authors.initials: S
authors.lastname: Downie
authors.forename: T H
authors.initials: TH
authors.lastname: Goodship
mesh_terms: D000138:Acidosis / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000097:blood; D001639:Bicarbonates / Q000627:therapeutic use; D001798:Blood Proteins / Q000378:metabolism*; D001823:Body Composition; D015992:Body Mass Index; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D007930:Leucine / Q000008:administration & dosage / Q000097:blood*; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*; D014508:Urea / Q000097:blood
chemical_list: D000596:Amino Acids; D001639:Bicarbonates; D001798:Blood Proteins; D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D014508:Urea; D007930:Leucine