Muscle protein metabolism during hemodialysis.
Despite improvement in many aspects of the care of maintenance hemodialysis (HD) patients, protein-calorie malnutrition, which is characterized by an insidious loss of somatic protein, is common and is a major risk factor for increased morbidity and mortality. We present here an overview of the current knowledge on protein metabolism in uremic patients with the expectation of providing insights into the mechanisms involved in HD-associated catabolism and outlining the rationale underlying intradialytic nutrition. We concentrate on the discussion of muscle protein metabolism because muscle is the predominant site of protein storage, and its integrity is mandatory for the maintenance of a good quality of life.
Bohé
Julien
J
JE2411 and Medical Intensive Care Unit, Lyon-Sud University Hospital, Pierre-Bénite, France. julien.bohe@chu-lyon.fr
Rennie
Michael J
MJ
D000138:Acidosis; D000596:Amino Acids / Q000097:blood; D001158:Arteries; D001672:Biocompatible Materials; D015314:Dialysis Solutions / Q000737:chemistry; D004789:Enzyme Activation; D006706:Homeostasis; D006801:Humans; D007249:Inflammation / Q000209:etiology; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D009124:Muscle Proteins / Q000096:biosynthesis / Q000378:metabolism*; D018482:Muscle, Skeletal / Q000098:blood supply / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism; D009747:Nutritional Physiological Phenomena; D046988:Proteasome Endopeptidase Complex / Q000378:metabolism; D011506:Proteins / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation; D025801:Ubiquitin / Q000378:metabolism; D014511:Uremia / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D014680:Veins
D000596:Amino Acids; D001672:Biocompatible Materials; D015314:Dialysis Solutions; D009124:Muscle Proteins; D011506:Proteins; D025801:Ubiquitin; D046988:Proteasome Endopeptidase Complex; D009584:Nitrogen