Nephrology Dialysis Transplantation, Vol 12, Issue 11 2397-2401, Copyright © 1997 by Oxford University Press
J Kooman, N Deutz, P Zijlmans, A an den Wall Bake, P Gerlag, F van Hooff and K Leunissen
Background: It has been hypothesized that correction
of metabolic acidosis might improve the nutritional state of acidotic
haemodialysis (HD) patients partly because of a reduced oxidation of
branched-chain amino acids (BCAA). Aim: We
investigated whether bicarbonate (Bic) supplementation in acidotic HD
patients results in increased plasma levels of BCAA.
Methods: In a longitudinal study (run-in period, 2
months; study period, 6 months), the effect of Bic supplementation on
plasma levels of BCAA was studied in 12 acidotic HD patients (7 men, 5
women, mean age 54±18 years) with a predialysis bicarbonate
(Bic) concentration smaller or equal to 22 mmol/l. Bic was supplemented by
increasing Bic concentration of the dialysate and by oral Bic
supplementation. Results: Predialysis Bic increased
significantly during the study period (18.7±2.7
vs 23.1±11.5 mmol/l). There was no change
in nutritional parameters. However, plasma levels of the BCAA valine,
leucine, and isoleucine increased significantly.
Conclusions: In haemodialysis patients with metabolic
acidosis, Bic supplementation over a 6-months period resulted in an
increase in plasma levels of BCAA. Further study is needed to elucidate the
mechanisms behind, and the clinical importance of the observed changes in
plasma BCAA levels.
PRELIMINARY REPORTS
The influence of bicarbonate supplementation on plasma levels of branched-chain amino acids in haemodialysis patients with metabolic acidosis
Department of Internal Medicine, University Hospital Maastricht, The Netherlands; Department of Surgery, University of Limburg, Maastricht, The Netherlands; St Joseph Hospital Veldhoven, The Netherlands; Corresponding author at: Department of Internal Medicine, PO Box 5800, 6202 AZ Maastricht, The Netherlands
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