The metabolic response to ingested protein is normal in long-term hemodialysis patients.
BACKGROUND
Protein-energy malnutrition affects 30% to 50% of hemodialysis (HD) patients. This has been attributed to inadequate food intake, but may be caused by disturbances in utilization of ingested protein.


METHODS
We studied protein kinetics during fasting and during ingestion of a protein-enriched meal to investigate possible metabolic differences between stable HD patients and control subjects. Whole-body protein kinetics was measured by means of a primed constant infusion of L[1-13C] valine.


RESULTS
During fasting, whole-body protein balance was significantly less negative in HD patients compared with control subjects. During meal intake, protein balance was similar between HD patients and control subjects. Meal intake increased protein balance significantly in both groups, but not differently between the groups. Also, protein oxidation was decreased during fasting in HD patients compared with control subjects, but not during meal intake.


CONCLUSIONS
We conclude that the rate of protein breakdown is lower in HD patients compared with control subjects, but the efficiency of protein utilization is normal in HD patients during a nondialysis day.
Veeneman
Jorden M
JM
Department of Internal Medicine, Division of Nephrology, University Hospital Groningen, Groningen, The Netherlands.
Kingma
Hermi A
HA
Boer
Theo S
TS
Stellaard
Frans
F
de Jong
Paul E
PE
Reijngoud
Dirk-Jan
DJ
Huisman
Roel M
RM
D000328:Adult; D001944:Breath Tests; D002247:Carbon Isotopes; D004044:Dietary Proteins / Q000378:metabolism*; D002149:Energy Intake; D004734:Energy Metabolism; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D006435:Renal Dialysis; D014633:Valine / Q000378:metabolism
D002247:Carbon Isotopes; D004044:Dietary Proteins; D014633:Valine