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Morbid obesity in a young woman affected by advanced chronic kidney disease: an exceptional case report. Does a high dose of essential amino acids play a key role in therapeutic success?
Nutr Diabetes. 2016 Feb 29; 6:e196.ND

Abstract

A 38-year-old woman, obese (219 kg), diabetic, hypertensive, chronic kidney disease (CKD) stage 4, with low plasma albumin level (2.9 g dl(-1)) and marked proteinuria (22 g per day) was studied. Given the advanced-stage CKD with nephrotic proteinuria, we supplemented low-protein diet with high doses of a tailored essential amino acid mixture (AAs: 44 g per day) to improve weight reduction in the patient. After 20 months of conservative therapy, the patient lost 43 kg; despite two episodes of infection, albumin plasma levels increased up to 3.7 g per day. After a further 20 months of dialysis, the patient maintained a diet of 1800 kcal supplemented with 32 g of AAs and lost 47 kg, whereas both albumin (3.89±0.12 g dl(-1)) and C reactive protein returned to normal. During the follow-up period, anemia improved, erythropoietin was thus discontinued and insulin requirement decreased to 105 IU. This therapeutic option may be beneficial in advanced CKD patients with obesity and diabetes resulting from malnutrition.

Authors+Show Affiliations

S.C. Territoriale di Nefrologia e Dialisi, ASL Cagliari, Quartu Sant'Elena, Italy.S.C. Territoriale di Nefrologia e Dialisi, ASL Cagliari, Quartu Sant'Elena, Italy.Anestesia e Rianimazione, Ospedale Marino, ASL Cagliari, Quartu Sant'Elena, Italy.Dipartimento di Scienze Cliniche e di Comunità-Università degli Studi Milano, Milano, Italy.S.C. Territoriale di Nefrologia e Dialisi, ASL Cagliari, Quartu Sant'Elena, Italy.S.C. Territoriale di Nefrologia e Dialisi, ASL Cagliari, Quartu Sant'Elena, Italy.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26926587

Citation

Caria, S, et al. "Morbid Obesity in a Young Woman Affected By Advanced Chronic Kidney Disease: an Exceptional Case Report. Does a High Dose of Essential Amino Acids Play a Key Role in Therapeutic Success?" Nutrition & Diabetes, vol. 6, 2016, pp. e196.
Caria S, Murtas S, Loria G, et al. Morbid obesity in a young woman affected by advanced chronic kidney disease: an exceptional case report. Does a high dose of essential amino acids play a key role in therapeutic success? Nutr Diabetes. 2016;6:e196.
Caria, S., Murtas, S., Loria, G., Dioguardi, F. S., Secci, R., & Bolasco, P. (2016). Morbid obesity in a young woman affected by advanced chronic kidney disease: an exceptional case report. Does a high dose of essential amino acids play a key role in therapeutic success? Nutrition & Diabetes, 6, e196. https://doi.org/10.1038/nutd.2016.4
Caria S, et al. Morbid Obesity in a Young Woman Affected By Advanced Chronic Kidney Disease: an Exceptional Case Report. Does a High Dose of Essential Amino Acids Play a Key Role in Therapeutic Success. Nutr Diabetes. 2016 Feb 29;6:e196. PubMed PMID: 26926587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Morbid obesity in a young woman affected by advanced chronic kidney disease: an exceptional case report. Does a high dose of essential amino acids play a key role in therapeutic success? AU - Caria,S, AU - Murtas,S, AU - Loria,G, AU - Dioguardi,F S, AU - Secci,R, AU - Bolasco,P, Y1 - 2016/02/29/ PY - 2015/06/17/received PY - 2015/09/04/revised PY - 2016/01/05/accepted PY - 2016/3/2/entrez PY - 2016/3/2/pubmed PY - 2016/3/2/medline SP - e196 EP - e196 JF - Nutrition & diabetes JO - Nutr Diabetes VL - 6 N2 - A 38-year-old woman, obese (219 kg), diabetic, hypertensive, chronic kidney disease (CKD) stage 4, with low plasma albumin level (2.9 g dl(-1)) and marked proteinuria (22 g per day) was studied. Given the advanced-stage CKD with nephrotic proteinuria, we supplemented low-protein diet with high doses of a tailored essential amino acid mixture (AAs: 44 g per day) to improve weight reduction in the patient. After 20 months of conservative therapy, the patient lost 43 kg; despite two episodes of infection, albumin plasma levels increased up to 3.7 g per day. After a further 20 months of dialysis, the patient maintained a diet of 1800 kcal supplemented with 32 g of AAs and lost 47 kg, whereas both albumin (3.89±0.12 g dl(-1)) and C reactive protein returned to normal. During the follow-up period, anemia improved, erythropoietin was thus discontinued and insulin requirement decreased to 105 IU. This therapeutic option may be beneficial in advanced CKD patients with obesity and diabetes resulting from malnutrition. SN - 2044-4052 UR - https://www.unboundmedicine.com/medline/citation/26926587/Morbid_obesity_in_a_young_woman_affected_by_advanced_chronic_kidney_disease:_an_exceptional_case_report__Does_a_high_dose_of_essential_amino_acids_play_a_key_role_in_therapeutic_success L2 - https://doi.org/10.1038/nutd.2016.4 DB - PRIME DP - Unbound Medicine ER -