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Coordinated increase in albumin, fibrinogen, and muscle protein synthesis during hemodialysis: role of cytokines.
Am J Physiol Endocrinol Metab 2004; 286(4):E658-64AJ

Abstract

Serum albumin, fibrinogen levels, and lean body mass are important predictors of outcome in end-stage renal disease (ESRD). We estimated the fractional synthesis rates of albumin (FSR-A), fibrinogen (FSR-F), and muscle protein (FSR-M) in nine ESRD patients and eight controls, using primed constant infusion of l-[ring-(13)C(6)]phenylalanine. Cytokine profile and arteriovenous balance of amino acids were also measured. ESRD patients were studied before (Pre-HD) and during hemodialysis (HD). Plasma IL-6, IL-10, and C-reactive protein increased significantly during HD. Despite a decrease in the delivery of amino acids to the leg, the outflow of the amino acids increased during HD. The net balance of amino acids became more negative during HD, indicating release from the muscle. HD increased leg muscle protein synthesis (45%) and catabolism (108%) but decreased whole body proteolysis (15%). FSR-A during HD (9.7 +/- 0.9%/day) was higher than pre-HD (6.5 +/- 0.9%/day) and controls (5.8 +/- 0.5%/day, P < 0.01). FSR-F increased during HD (19.7 +/- 2.6%/day vs. 11.8 +/- 0.6%/day, P < 0.01), but it was not significantly different from that of controls (14.4 +/- 1.4%/day). FSR-M intradialysis (1.77 +/- 0.19%/day) was higher than pre-HD (1.21 +/- 0.25%/day) and controls (1.30 +/- 0.32%/day, P < 0.001). Pre-HD FSR-A, FSR-F, and FSR-M values were comparable to those of controls. There was a significant and positive correlation between plasma IL-6 and the FSRs. Thus, in ESRD patients without metabolic acidosis, the fractional synthesis rates of albumin, fibrinogen, and muscle protein are not decreased pre-HD. However, HD increases the synthesis of albumin, fibrinogen, and muscle protein. The coordinated increase in the FSRs is facilitated by constant delivery of amino acids derived from the muscle catabolism and intradialytic increase in IL-6.

Authors+Show Affiliations

Division of Nephrology, ACC 5th Floor, University of New Mexico Health Sciences Center, 2211 Lomas Boulevard NE, Albuquerque, NM 87131, USA. draj@salud.unm.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14722024

Citation

Raj, Dominic S C., et al. "Coordinated Increase in Albumin, Fibrinogen, and Muscle Protein Synthesis During Hemodialysis: Role of Cytokines." American Journal of Physiology. Endocrinology and Metabolism, vol. 286, no. 4, 2004, pp. E658-64.
Raj DS, Dominic EA, Wolfe R, et al. Coordinated increase in albumin, fibrinogen, and muscle protein synthesis during hemodialysis: role of cytokines. Am J Physiol Endocrinol Metab. 2004;286(4):E658-64.
Raj, D. S., Dominic, E. A., Wolfe, R., Shah, V. O., Bankhurst, A., Zager, P. G., & Ferrando, A. (2004). Coordinated increase in albumin, fibrinogen, and muscle protein synthesis during hemodialysis: role of cytokines. American Journal of Physiology. Endocrinology and Metabolism, 286(4), pp. E658-64.
Raj DS, et al. Coordinated Increase in Albumin, Fibrinogen, and Muscle Protein Synthesis During Hemodialysis: Role of Cytokines. Am J Physiol Endocrinol Metab. 2004;286(4):E658-64. PubMed PMID: 14722024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coordinated increase in albumin, fibrinogen, and muscle protein synthesis during hemodialysis: role of cytokines. AU - Raj,Dominic S C, AU - Dominic,Elizabeth A, AU - Wolfe,Robert, AU - Shah,Vallabh O, AU - Bankhurst,Arthur, AU - Zager,Philip G, AU - Ferrando,Arny, Y1 - 2004/01/13/ PY - 2004/1/15/pubmed PY - 2004/4/16/medline PY - 2004/1/15/entrez SP - E658 EP - 64 JF - American journal of physiology. Endocrinology and metabolism JO - Am. J. Physiol. Endocrinol. Metab. VL - 286 IS - 4 N2 - Serum albumin, fibrinogen levels, and lean body mass are important predictors of outcome in end-stage renal disease (ESRD). We estimated the fractional synthesis rates of albumin (FSR-A), fibrinogen (FSR-F), and muscle protein (FSR-M) in nine ESRD patients and eight controls, using primed constant infusion of l-[ring-(13)C(6)]phenylalanine. Cytokine profile and arteriovenous balance of amino acids were also measured. ESRD patients were studied before (Pre-HD) and during hemodialysis (HD). Plasma IL-6, IL-10, and C-reactive protein increased significantly during HD. Despite a decrease in the delivery of amino acids to the leg, the outflow of the amino acids increased during HD. The net balance of amino acids became more negative during HD, indicating release from the muscle. HD increased leg muscle protein synthesis (45%) and catabolism (108%) but decreased whole body proteolysis (15%). FSR-A during HD (9.7 +/- 0.9%/day) was higher than pre-HD (6.5 +/- 0.9%/day) and controls (5.8 +/- 0.5%/day, P < 0.01). FSR-F increased during HD (19.7 +/- 2.6%/day vs. 11.8 +/- 0.6%/day, P < 0.01), but it was not significantly different from that of controls (14.4 +/- 1.4%/day). FSR-M intradialysis (1.77 +/- 0.19%/day) was higher than pre-HD (1.21 +/- 0.25%/day) and controls (1.30 +/- 0.32%/day, P < 0.001). Pre-HD FSR-A, FSR-F, and FSR-M values were comparable to those of controls. There was a significant and positive correlation between plasma IL-6 and the FSRs. Thus, in ESRD patients without metabolic acidosis, the fractional synthesis rates of albumin, fibrinogen, and muscle protein are not decreased pre-HD. However, HD increases the synthesis of albumin, fibrinogen, and muscle protein. The coordinated increase in the FSRs is facilitated by constant delivery of amino acids derived from the muscle catabolism and intradialytic increase in IL-6. SN - 0193-1849 UR - https://www.unboundmedicine.com/medline/citation/14722024/Coordinated_increase_in_albumin_fibrinogen_and_muscle_protein_synthesis_during_hemodialysis:_role_of_cytokines_ L2 - http://www.physiology.org/doi/full/10.1152/ajpendo.00444.2003?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -