title: Amino acid and protein metabolism in the human kidney and in patients with chronic kidney disease.
abstract: The progressive loss of kidney function in patients with chronic kidney disease (CKD) is associated with a number of complications, including cardiovascular diseases, anemia, hyperparathyroidism, inflammation, metabolic acidosis, malnutrition and protein-energy wasting. The excess cardiovascular risk related to CKD is due in part to a higher prevalence of traditional atherosclerotic risk factors, in part to non-traditional, emerging risk factors peculiar to CKD. While even minor renal dysfunction is an independent predictor of adverse cardiovascular prognosis, nutritional changes are more often observed in an advanced setting. In addition, factors related to renal-replacement treatment may be implicated in the pathogenesis of heart disease and protein-energy wasting in dialysis-treated patients. Progressive alterations in kidney metabolism may cause progressive effects on cardiovascular status and nutrition. Altered kidney amino acid/protein metabolism and or excretion may be a key factor in the homeostasis of several vasoactive compounds and hormones in patients with more advanced disease. In this discussion recent research regarding the kidney handling of amino acids and protein turnover and their potential link with cardiovascular disease, progressive kidney dysfunction and nutritional status are reviewed.
authors.affiliation: Department of Internal Medicine, University of Genoa, Genoa, Italy. gari@unige.it
authors.forename: Giacomo
authors.initials: G
authors.lastname: Garibotto
authors.forename: Antonella
authors.initials: A
authors.lastname: Sofia
authors.forename: Stefano
authors.initials: S
authors.lastname: Saffioti
authors.forename: Alice
authors.initials: A
authors.lastname: Bonanni
authors.forename: Irene
authors.initials: I
authors.lastname: Mannucci
authors.forename: Daniela
authors.initials: D
authors.lastname: Verzola
mesh_terms: D000596:Amino Acids / Q000378:metabolism*; D000818:Animals; D004044:Dietary Proteins / Q000009:adverse effects / Q000378:metabolism*; D018450:Disease Progression; D006801:Humans; D007668:Kidney / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D011506:Proteins / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods
chemical_list: D000596:Amino Acids; D004044:Dietary Proteins; D011506:Proteins