Intracellular amino acids in uremia
Alvestrand, A.; Fürst, P.; Bergström, J.
Kidney International. Supplement 16: S9-16
1983
ISSN/ISBN: 0098-6577 PMID: 6429407 Document Number: 211422
Uraemia is characterized by a specific intracellular amino acid (AA) pattern in muscle, which is not consistently reflected by that in plasma. Results with different AA formulae indicate that abnormal intracellular AA concentrations can be corrected by nutritional treatment which adjusts for the specific AA abnormalities of uraemia. Restoration of the intracellular free AA pools to normal may be associated with better nitrogen utilization. That implies that uraemic patients require essential AA in proportions other than those needed by normal persons. Estimation of intracellular free AA in muscle tissue obtained by needle biopsy is valuable for tailoring AA supplement to uraemic patients. Based on those observations, tentative recommendations are that in patients treated with a low-protein diet, that should be supplemented with an essential AA mixture containing tyrosine and with greater proportion of valine and smaller proportion of leucine than those recommended for normal persons. The nutritional effect of valine supplement should be studied in patients on haemodialysis, in whom valine pools were smaller in spite of a protein intake of 1 g/kg daily.