title: Effects of feeding on albumin synthesis in hypoalbuminemic hemodialysis patients.
abstract: BACKGROUND
  Hypoalbuminemia is a powerful predictor of morbidity and mortality in hemodialysis (HD) patients and results from a reduction in albumin synthesis. It is not known if this is associated with any impairment of the normal response to feeding.
  
  
  METHODS
  Protein turnover and albumin synthesis were measured in the fasting and fed state using a primed constant infusion of L-[1-(13)C]leucine in seven hypoalbuminemic (albumin < or = 36 g/L) HD patients (HHD), seven normoalbuminemic (albumin > or = 40 g/L) HD patients (NHD) and nine age-matched normal controls.
  
  
  RESULTS
  The increase in albumin synthesis on feeding was impaired in HHD patients (fasting 15.0 +/- 1.5 vs. fed 17.7 +/- 2.9%, P = NS) compared to NHD (fasting 13.7 +/- 0.9 vs. fed 17.4 +/- 1.0%, P < 0.05) and controls (fasting 12.9 +/- 0.6 vs. fed 15.2 +/- 0.6%, P < 0.05). In addition, body mass index and percent body fat were significantly (P < 0.05) lower in HHD (20.8 +/- 1.3 kg/m2, 23.4 +/- 2.0%) than NHD (26.7 +/- 1.3 kg/m2, 33.1 +/- 3.2%) or controls (26.2 +/- 1.1 kg/m2, 32.6 +/- 1.8%). There was no difference in dietary protein or energy intake in the three groups.
  
  
  CONCLUSIONS
  There are differences of body composition and protein metabolism in HHD patients that may be related to an impaired metabolic response to feeding.
authors.affiliation: School of Clinical Medical Sciences and Biomedical Mass Spectrometry Unit, Royal Victoria Infirmary, University of Newcastle upon Tyne, Newcastle-upon-Tyne NE1 4LP, England, UK.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Louden
authors.forename: Kim
authors.initials: K
authors.lastname: Bartlett
authors.forename: David
authors.initials: D
authors.lastname: Reaich
authors.forename: Rachel
authors.initials: R
authors.lastname: Edson
authors.forename: Clare
authors.initials: C
authors.lastname: Alexander
authors.forename: Timothy H J
authors.initials: TH
authors.lastname: Goodship
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000096:biosynthesis*; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D002097:C-Reactive Protein / Q000032:analysis; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007930:Leucine / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D000418:Albumins; D001786:Blood Glucose; D004044:Dietary Proteins; D007328:Insulin; D012709:Serum Albumin; D002097:C-Reactive Protein; D007930:Leucine