Amino-acid-based peritoneal dialysis solution improves amino-acid transport into skeletal muscle.
Abnormalities of amino-acid (AA) and protein metabolism are known to occur in chronic kidney disease (CKD). Protein malnutrition may contribute to impaired prognosis of dialysis patients. A crucial step in protein metabolism is AA transport into the cells. We compared the effects of an AA-containing peritoneal dialysis (PD) solution to glucose-based solutions on skeletal muscle AA uptake. Thirteen nondiabetic PD patients were studied twice in a random order and in a crossover manner both in the fasting state and during euglycemic insulin stimulation using [(11)C]methylaminoisobutyrate ([(11)C]MeAIB) and positron emission tomography (PET). Before both PET study days, patients had been using either glucose-based PD solutions only or one daily bag of AA solution in addition to glucose-based PD solutions for at least 6 weeks. Skeletal muscle AA uptake was calculated with graphical analysis. AA-containing PD solution increased plasma AA concentrations from 2.18+/-0.34 to 3.08+/-0.55 mmol l(-1) in the fasting state (P=0.0002) and from 1.88+/-0.15 to 2.42+/-0.30 mmol l(-1) during insulin stimulation (P<0.0001). As compared to PD treatment using glucose-based solutions only, skeletal muscle AA uptake was significantly higher during treatment containing AA solution both in the fasting state (15.2+/-5.8 vs 20.0+/-5.6 micromol kg(-1) min(-1), respectively, P=0.0057) and during insulin stimulation (16.8+/-4.5 vs 21.1+/-4.9 micromol kg(-1) min(-1), respectively, P=0.0046). In conclusion, PD treatment with an AA-containing PD solution is associated with a significant increase in skeletal muscle AA uptake both in the fasting state and during insulin stimulation.
Asola
M
M
Department of Medicine, Satakunta Central Hospital, Pori, Finland. markku.asola@satshp.fi
Virtanen
K
K
Någren
K
K
Helin
S
S
Taittonen
M
M
Kastarinen
H
H
Anderstam
B
B
Knuuti
J
J
Metsärinne
K
K
Nuutila
P
P
D000368:Aged; D000596:Amino Acids / Q000378:metabolism* / Q000494:pharmacology*; D001692:Biological Transport / Q000187:drug effects; D002908:Chronic Disease; D018592:Cross-Over Studies; D015314:Dialysis Solutions / Q000494:pharmacology*; D005260:Female; D005947:Glucose / Q000494:pharmacology; D006801:Humans; D007674:Kidney Diseases / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D010530:Peritoneal Dialysis / Q000379:methods*; D049268:Positron-Emission Tomography
D000596:Amino Acids; D015314:Dialysis Solutions; D005947:Glucose