title: Peritoneal dialysis with solutions containing amino acids plus glucose promotes protein synthesis during oral feeding.
abstract: Inadequate food intake plays an important role in the development of malnutrition. Recently, an increased rate of protein anabolism was shown in fasting state in patients who were on automated peritoneal dialysis with combined amino acids (AA) and glucose (G) dialysate serving as a source of both proteins and calories. This study investigated the effects of such a dialysis procedure in the daytime in the fed state in patients who were on continuous ambulatory peritoneal dialysis (CAPD). A crossover study was performed in 12 CAPD patients to compare, at 7-d intervals, a mixture of AA (Nutrineal 1.1%) plus G (Physioneal l.36 to 3.86%) versus G only as control dialysate. Whole-body protein turnover was studied by primed constant intravenous infusion of (13)C-leucine during the 9-h dialysis. For meeting steady-state conditions during whole-body protein turnover, frequent exchanges with a mixture of AA plus G were done using an automated cycler. Fed-state conditions were created by identical liquid hourly meals. Using AA plus G dialysate, as compared with the control, rates of protein synthesis increased significantly (2.02 +/- 0.08 versus 1.94 +/- 0.07 mumol leucine/kg per min [mean +/- SEM]; P = 0.039). Rates of protein breakdown and net protein balance did not differ significantly between AA plus G and G. In conclusion, dialysate that contains AA plus G also improves protein synthesis in fed CAPD patients. The use of such a mixture may contribute to long-term improvement of the nutritional status in malnourished CAPD patients with deficient food intake.
authors: Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands. h.tjiong@erasmusmc.nl
authors: Hoey Lan
authors: HL
authors: Tjiong
authors: Trinet
authors: T
authors: Rietveld
authors: Josias L
authors: JL
authors: Wattimena
authors: Jacobus W
authors: JW
authors: van den Berg
authors: Devada
authors: D
authors: Kahriman
authors: José
authors: J
authors: van der Steen
authors: Wim C
authors: WC
authors: Hop
authors: Roel
authors: R
authors: Swart
authors: Marien W
authors: MW
authors: Fieren
mesh_terms: D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage*; D002247:Carbon Isotopes; D018592:Cross-Over Studies; D015314:Dialysis Solutions / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000493:pharmacokinetics; D004435:Eating; D002149:Energy Intake; D004734:Energy Metabolism / Q000187:drug effects; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000178:diet therapy / Q000378:metabolism / Q000628:therapy*; D007930:Leucine / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D014176:Protein Biosynthesis / Q000187:drug effects; D011502:Protein-Energy Malnutrition / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000378:metabolism; D011877:Radionuclide Imaging
chemical_list: D000596:Amino Acids; D002247:Carbon Isotopes; D015314:Dialysis Solutions; D004044:Dietary Proteins; D007930:Leucine; D005947:Glucose