PT  - JOURNAL ARTICLE
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
TI  - Dialysate as Food: Combined Amino Acid and Glucose Dialysate Improves Protein Anabolism in Renal Failure Patients on Automated Peritoneal Dialysis
AID  - 10.1681/ASN.2004050402
DP  - 2005 May 01
TA  - Journal of the American Society of Nephrology
PG  - 1486--1493
VI  - 16
IP  - 5
4099  - http://jasn.asnjournals.org/content/16/5/1486.short
4100  - http://jasn.asnjournals.org/content/16/5/1486.full
SO  - J. Am. Soc. Nephrol.2005 May 01; 16
AB  - 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 μmol/kg per min leucine (mean ± SD), respectively (NS), and protein breakdown rates were 1.60 ± 0.5 and 1.72 ± 0.3 μmol/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 μmol 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.