title: A novel amino acids oral supplementation in hemodialysis patients: a pilot study.
abstract: BACKGROUND
  Protein malnutrition and lowering serum albumin is frequent in hemodialysis patients. A special amino acid formulation has recently been used with favorable effects in elderly people but no data exist in renal patients.
  
  
  OBJECTIVE
  To assess the effects of this novel amino acid formulation in stable hemodialysis patients with reduced albumin levels.
  
  
  METHODS
  Thirty stable hemodialysis patients with serum albumin levels <3.5 g/dL, normalized protein nitrogen appearance (nPNA) <1.1 g/kg/d, and body mass index (BMI) >20 kg/m(2) were selected: 15 patients were randomized to oral amino acid supplementation (4 g thrice a day) for 3 months and 15 patients comparable for age, gender, and dialysis durations formed the control group. Biochemistry and bioimpedentiometry parameters were measured at baseline and at the end of treatment.
  
  
  RESULTS
  No difference was observed between study group and control group at baseline. At the end of the study period, no change occurred in the studied parameters in the control group, whereas increase in serum albumin (3.1 ± 0.3 vs. 3.6 ± 0.2 g/dL, p < 0.001) and in total proteins (5.7 ± 0.4 vs. 6.4 ± 0.7 g/dL, p < 0.001) occurred in the study group. Hemoglobin rose from 10.7 ± 0.9 to 11.7 ± 0.8 g/dL (p < 0.05) at the same erythropoiesis-stimulating agent (ESA) dosage. C-Reactive protein (CRP) levels decreased in the study group (8.7 ± 7.3 vs. 3.8 ± 3.1 mg/L, p < 0.01). Increase of body weight and of equilibrated protein catabolic rate (ePCR) was observed in the study group.
  
  
  CONCLUSIONS
  Oral amino acids supplementation was able to improve albumin and total protein in hypoalbuminemia hemodialysis patients. This effect was associated with reduction of CRP levels that is with lowering of pro-inflammatory status and anemia improvement.
authors.affiliation: Territorial Department of Nephrology and Dialysis, ASL, Cagliari, Italy. pg.bolasco@tin.it
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Bolasco
authors.forename: Stefania
authors.initials: S
authors.lastname: Caria
authors.forename: Adamasco
authors.initials: A
authors.lastname: Cupisti
authors.forename: Romina
authors.initials: R
authors.lastname: Secci
authors.forename: Francesco
authors.initials: F
authors.lastname: Saverio Dioguardi
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000178:diet therapy*; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis
chemical_list: D000596:Amino Acids; D012709:Serum Albumin