title: [Amino acid loss during dialysis treatment].
abstract: Protein-calorie malnutrition is a widespread complication in hemodialysis (HD) patients and is associated with increased mortality. The pathogenesis of malnutrition is multifactorial. Intradialytic amino acid (AA) loss is considered one of the cofactors in the complex mechanisms that lead to malnutrition in HD patients. It has been documented that in each dialysis session there is a 6-8 gram loss of AA into the dialysate, which worsens with the use of high-flux membranes. The intradialytic AA loss is variably compensated by reduction of liver synthesis and increased AA release from muscle stores. In malnourished HD patients the serum AA concentration, especially branched-chain AA (BCAA), is correlated with nutritional status and anorexia, whereas BCAA supplementation improves the nutritional parameters and increases appetite. Further studies are necessary to clarify the role of alterations of AA metabolism in the pathogenesis of malnutrition and the potential beneficial effects of BCAA supplementation or alternative treatments in malnourished patients.
authors.affiliation: Cattedra di Nefrologia, Seconda Universita' di Napoli, Napoli, Italy. silvio_borrelli@libero.it
authors.forename: Silvio
authors.initials: S
authors.lastname: Borrelli
authors.forename: Luca
authors.initials: L
authors.lastname: De Nicola
authors.forename: Adelia
authors.initials: A
authors.lastname: Sagliocca
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Liberti
authors.forename: Sara
authors.initials: S
authors.lastname: Santangelo
authors.forename: Gerardo
authors.initials: G
authors.lastname: Donnarumma
authors.forename: Carlo
authors.initials: C
authors.lastname: Garofalo
authors.forename: Mario
authors.initials: M
authors.lastname: Pacilio
authors.forename: Pasquale
authors.initials: P
authors.lastname: Zamboli
authors.forename: Roberto
authors.initials: R
authors.lastname: Minutolo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Conte
mesh_terms: D000596:Amino Acids / Q000378:metabolism*; D006801:Humans; D011502:Protein-Energy Malnutrition / Q000209:etiology* / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D000596:Amino Acids