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Dialysate as food: combined amino acid and glucose dialysate improves protein anabolism in renal failure patients on automated peritoneal dialysis.
J Am Soc Nephrol. 2005 May; 16(5):1486-93.JA

Abstract

Protein-energy malnutrition as a result of anorexia frequently occurs in dialysis patients. In patients who are on peritoneal dialysis (PD), dialysate that contains amino acids (AA) improves protein anabolism when combined with a sufficient oral intake of calories. It was investigated whether protein anabolism can be obtained with a mixture of AA plus glucose (G) as a source of proteins and calories during nocturnal automated PD (APD). A random-order cross-over study was performed in eight APD patients to compare in two periods of 7 d each AA plus G dialysate obtained by cycler-assisted mixing of one bag of 2.5 L of AA (Nutrineal 1.1%, 27 g of AA) and four bags of 2.5 L of G (Physioneal 1.36 to 3.86%) versus G as control dialysate. Whole-body protein turnover was determined using a primed continuous infusion of L-[1-13C]leucine, and 24-h nitrogen balance studies were performed. During AA plus G dialysis, when compared with control, rates of protein synthesis were 1.20 +/- 0.4 and 1.10 +/- 0.2 micromol/kg per min leucine (mean +/- SD), respectively (NS), and protein breakdown rates were 1.60 +/- 0.5 and 1.72 +/- 0.3 micromol/kg per min (NS). Net protein balance (protein synthesis minus protein breakdown) increased on AA plus G in all patients (mean 0.21 +/- 0.12 micromol leucine/kg per min; P < 0.001). The 24-h nitrogen balance changed by 0.96 +/- 1.21 g/d, from -0.60 +/- 2.38 to 0.35 +/- 3.25 g/d (P = 0.061, NS), improving in six patients. In conclusion, APD with AA plus G dialysate improves protein kinetics. This dialysis procedure may improve the nutritional status in malnourished PD patients.

Authors+Show Affiliations

Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands. h.tjiong@erasmusmc.nlNo affiliation info availableNo affiliation info availableNo 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
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15800130

Citation

Tjiong, Hoey Lan, et al. "Dialysate as Food: Combined Amino Acid and Glucose Dialysate Improves Protein Anabolism in Renal Failure Patients On Automated Peritoneal Dialysis." Journal of the American Society of Nephrology : JASN, vol. 16, no. 5, 2005, pp. 1486-93.
Tjiong HL, van den Berg JW, Wattimena JL, et al. Dialysate as food: combined amino acid and glucose dialysate improves protein anabolism in renal failure patients on automated peritoneal dialysis. J Am Soc Nephrol. 2005;16(5):1486-93.
Tjiong, H. L., van den Berg, J. W., Wattimena, J. L., Rietveld, T., van Dijk, L. J., van der Wiel, A. M., van Egmond, A. M., Fieren, M. W., & Swart, R. (2005). Dialysate as food: combined amino acid and glucose dialysate improves protein anabolism in renal failure patients on automated peritoneal dialysis. Journal of the American Society of Nephrology : JASN, 16(5), 1486-93.
Tjiong HL, et al. Dialysate as Food: Combined Amino Acid and Glucose Dialysate Improves Protein Anabolism in Renal Failure Patients On Automated Peritoneal Dialysis. J Am Soc Nephrol. 2005;16(5):1486-93. PubMed PMID: 15800130.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dialysate as food: combined amino acid and glucose dialysate improves protein anabolism in renal failure patients on automated peritoneal dialysis. AU - Tjiong,Hoey Lan, AU - van den Berg,Jacobus W, AU - Wattimena,Josias L, AU - Rietveld,Trinet, AU - van Dijk,Laurens J, AU - van der Wiel,Adorée M, AU - van Egmond,Anneke M, AU - Fieren,Marien W, AU - Swart,Roel, Y1 - 2005/03/30/ PY - 2005/4/1/pubmed PY - 2005/9/1/medline PY - 2005/4/1/entrez SP - 1486 EP - 93 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 16 IS - 5 N2 - Protein-energy malnutrition as a result of anorexia frequently occurs in dialysis patients. In patients who are on peritoneal dialysis (PD), dialysate that contains amino acids (AA) improves protein anabolism when combined with a sufficient oral intake of calories. It was investigated whether protein anabolism can be obtained with a mixture of AA plus glucose (G) as a source of proteins and calories during nocturnal automated PD (APD). A random-order cross-over study was performed in eight APD patients to compare in two periods of 7 d each AA plus G dialysate obtained by cycler-assisted mixing of one bag of 2.5 L of AA (Nutrineal 1.1%, 27 g of AA) and four bags of 2.5 L of G (Physioneal 1.36 to 3.86%) versus G as control dialysate. Whole-body protein turnover was determined using a primed continuous infusion of L-[1-13C]leucine, and 24-h nitrogen balance studies were performed. During AA plus G dialysis, when compared with control, rates of protein synthesis were 1.20 +/- 0.4 and 1.10 +/- 0.2 micromol/kg per min leucine (mean +/- SD), respectively (NS), and protein breakdown rates were 1.60 +/- 0.5 and 1.72 +/- 0.3 micromol/kg per min (NS). Net protein balance (protein synthesis minus protein breakdown) increased on AA plus G in all patients (mean 0.21 +/- 0.12 micromol leucine/kg per min; P < 0.001). The 24-h nitrogen balance changed by 0.96 +/- 1.21 g/d, from -0.60 +/- 2.38 to 0.35 +/- 3.25 g/d (P = 0.061, NS), improving in six patients. In conclusion, APD with AA plus G dialysate improves protein kinetics. This dialysis procedure may improve the nutritional status in malnourished PD patients. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/15800130/Dialysate_as_food:_combined_amino_acid_and_glucose_dialysate_improves_protein_anabolism_in_renal_failure_patients_on_automated_peritoneal_dialysis_ L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=15800130 DB - PRIME DP - Unbound Medicine ER -