期刊
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM
卷 292, 期 6, 页码 E1534-E1542出版社
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpendo.00599.2006
关键词
protein turnover; cytokines; end-stage renal disease; malnutrition; caspase-3; skeletal muscle
资金
- NCRR NIH HHS [5 M01 RR-00997] Funding Source: Medline
- NIA NIH HHS [AG-21560] Funding Source: Medline
Intradialytic protein catabolism is attributed to loss of amino acids in the dialysate. We investigated the effect of amino acid infusion during hemodialysis ( HD) on muscle protein turnover and amino acid transport kinetics by using stable isotopes of phenylalanine, leucine, and lysine in eight patients with end- stage renal disease ( ESRD). Subjects were studied at baseline ( pre- HD), 2 h of HD without amino acid infusion ( HD-O), and 2 h of HD with amino acid infusion ( HD + AA). Amino acid depletion during HD-O augmented the outward transport of amino acids from muscle into the vein. Increased delivery of amino acids to the leg during HD + AA facilitated the transport of amino acids from the artery into the intracellular compartment. Increase in muscle protein breakdown was more than the increase in synthesis during HD-O ( 46.7 vs. 22.3%, P < 0.001). Net balance ( nmol . min(-1) . 100 ml(-1)) was more negative during HD-O compared with pre- HD ( -33.7 +/- 1.5 vs. -6.0 +/- 2.3, P < 0.001). Despite an abundant supply of amino acids, the net balance ( - 16.9 +/- 1.8) did not switch from net release to net uptake. HD + AA induced a proportional increase in muscle protein synthesis and catabolism. Branched chain amino acid catabolism increased significantly from baseline during HD- O and did not decrease during HD + AA. Protein synthesis efficiency, the fraction of amino acid in the intracellular pool that is utilized for muscle protein synthesis decreased from 42.1% pre- HD to 33.7 and 32.6% during HD- O and HD + AA, respectively ( P < 0.01). Thus amino acid repletion during HD increased muscle protein synthesis but did not decrease muscle protein breakdown.
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