Therapy with essential amino acids and their nitrogen-free analogues in severe renal failure
Patients with chronic renal failure are prescribed a low-protein diet to ease the workload of the kidneys; however, following a low-protein diet long term can cause a negative nitrogen balance, muscle wasting, amino acid deficiency, and neuropathy.
Supplementing with essential amino acids can help provide the necessary protein without putting such a stress on kidneys, and long-term supplementation has been shown to increase the reutilization of nitrogen, inhibit muscle wasting, and lessen the toxic effects of metabolites.
Number of Subjects
To investigate the effects of nutritional intervention with essential amino acids and their nitrogen-free keto and hydroxy acid precursors on negative nitrogen metabolism of patients with chronic renal insufficiency.
When patients were treated with essential amino acids and keto acid analogues of essential amino acids nitrogen balance increased to positive, plasma urea concentrations fell, and plasma amino acid levels rose.
Supplementation with a-hydroxy acid analogues showed an increase in nitrogen balance and methionine and histidine levels, while levels of other essential amino acids decreased.
Chronic renal failure patients on a low-protein diet who supplemented with essential amino acids or their keto acid analogues demonstrated improved protein and amino acid metabolism while patients with renal failure on a low-protein diet alone did not.
A low-protein diet can lead to a negative nitrogen balance and insufficient protein metabolism in chronic renal failure patients when followed over the long term. Supplementing with essential amino acids or their keto acid analogues can help shift nitrogen balance to positive and meet the protein needs of patients.
Bauerdick H, Spellerberg P, Lamberts B. Therapy with essential amino acids and their nitrogen-free analogues in severe renal failure. Am J Clin Nutr. 1978 Oct;31(10):1793-6. PMID:707334