Abstract
Acute and chronic uremia are associated with variable degrees of myopathy, a retardation in growth, and a reduction in lean body mass (1–3). With time, both the upper and lower extremities may demonstrate diffuse muscle atrophy and weakness (3). These data suggest that muscle protein catabolism may be increased, synthesis decreased, or both may coexist in uremia. Significant changes in plasma amino acids occur in both acute and chronic uremia. The plasma phenylalanine to tyrosine ratio is reduced and plasma non-essential amino acid levels are usually normal while the levels of essential amino acids including leucine, isoleucine, valine, and lysine are decreased (4, 5). These data suggest that significant abnormalities in protein metabolism do exist in uremia. Uremic rats fed identical diets exhibit significantly reduced growth rates compared to pair-fed control animals (6). Despite increased protein intake, growth was still impaired in the uremic animals. Thus, these data demonstrate that protein efficiency is reduced in the growing uremic animal. The mechanisms responsible for these observations have not been definitively elucidated.
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References
M. A. Holliday, and C. Chantler, Metabolic and nutritional factors in children with renal insufficiency, Kidney Int. 14: 306 1978.
C. Delaporte, G. Jean, and M. Broyer, Free plasma and muscle amino acids in uremic children, Am. J. Clin. Nutr. 31: 1647 1978.
M. Floyd, D. D. Ayyar, P. Barwick, and D. Weightman, Myopathy in chronic renal failure, Q. J. Med. 172: 509 1974.
L. Shear, Internal redistribution of tissue protein synthesis in uremia, J. Clin. Invest. 48: 1252 1969.
J. D. Kopple, and M. R. Jones, Amino acid metabolism in patients with advanced uremia and in patients undergoing chronic dialysis, Adv. Nephrol. 8: 233 1979.
M. Wang, I. Vyhmeister, J. D. Kopple, and M. E. Swendseid, Effect of protein intake on weight gain and plasma amino acid levels in uremic rats, Am. J. Physiol. 230: 1456 1976.
R. M. Flugel-Link, I.B. Salusky, M.R. Jones, J.D. Kopple, Enhanced muscle protein degradation and amino acid release from the hemicorpus of acutely uremic rats, in: “Proteases: Potential Role in Health and Disease,” W.H. Hörl, A. Heidland, eds., Plenum Press, New York (1983).
W. E. Mitch, Amino acid release from the hindquarter and urea appearance in acute uremia, Am. J. Physiol. 241: E415 1981.
V. R. Preedy, and P. J. Garlick, Rates of protein synthesis in skin and bones and their importance in the assessment of protein degradation in the perfused rat hemicorpus, Biochem. J. 194: 373 1981.
A. J. Garber, I. E. Karl, and D. M. Kipnis, Alanine and glutamine synthesis and release from skeletal muscle. I. Glycolysis and amino acid release, J. Biol. Chem. 251: 826 1976.
A. J. Garber, I. E. Karl, and D. M. Kipnis, Alanine and glutamine synthesis and release from skeletal muscle. II. The precursor role of amino acids in alanine and glutamine synthesis, J. Biol. Chem. 251: 836 1976.
I. E. Karl, A. J. Garber, and D. M. Kipnis, Alanine and glutamine synthesis and release from skeletal muscle. III. Dietary and hormonal regulation, J. Biol. Chem. 251: 844 1976.
A. J. Garber, I. E. Karl, and D. M. Kipnis, Alanine and glutamine synthesis and release from skeletal muscle. IV. B-adrenergic inhibition of amino acid release, J. Biol. Chem. 251: 851 1976.
H. R. Harter, I. E. Karl, S. Klahr, and D. M. Kipnis, Effects of reduced renal mass and dietary protein intake on amino acid release and glucose uptake by rat muscle in vitro. J. Clin. Invest. 64: 513 1979.
R. A. DeFronzo, A. Alvestrand, D. Smith, R. Hendler, E. Hendler, and J. Wahren, Insulin resistance in uremia, J. Clin. Invest. 67: 563 1981.
E. Slatopolsky, K. Martin, and K. Hruska, Parathyroid hormone metabolism and its potential as a uremic toxin, Am. J. Physiol. 239: F1 1980.
R. Gray, I. Boyle, and H. F. DeLuca, Vitamin D metabolism: The role of kidney tissue, Science 172: 1232 1971.
S. J. Birge, and J. G. Haddad, 25-hydroxycholecalciferol stimulation of muscle metabolism, J. Clin. Invest. 56: 1100 1975.
J. J. Pointon, M. J. O. Francis, and R. Smith, Effect of vitamin D deficiency on sarcoplasmic reticulum function and troponin C concentration of rabbit skeletal muscle, Clin. Sci. 57: 257 1979.
J. G. Haddad, and S. J. Birge, Widespread, specific binding of 25-hydroxycholecalciferol in rat tissues, J. Biol. Chem. 250: 299 1975.
H. R. Harter, S. J. Birge, K. J. Martin, S. Klahr, and I. E. Karl, The effects of vitamin D metabolites on the protein catabolism of muscle from uremic rats, Kidney Int. in press (1983).
A. J. Garber, Skeletal muscle protein and amino acid metabolism in experimental chronic uremia in the rat. Accelerated alanine and glutamine formation and release, J. Clin. Invest. 62: 623 1978.
A. J. Garber, The regulation of skeletal muscle alanine and glutamine formation and release in experimental chronic uremia in the rat. Subsensitivity of adenylate cyclase and amino acid release to epinephrine and serotonin, J. Clin. Invest. 62: 633 1978.
D. Smith, and R. A. DeFronzo, Insulin resistance in uremia mediated by postbinding defects, Kidney Int. 22: 54 1982.
V. Koivisto, V. Soman, E. Nadel, W. V. Tamborlane, and P. Felig, Exercise and insulin: Insulin binding, insulin mobilization and counter-regulatory hormone secretion, Fed. Proc. 39: 1481 1980.
C. S. Liang, R. R. Tuttle, W. B. Hood, and H. Gavras, Conditioning effects of chronic infusions of dobutamine: Comparison with exercise training, J. Clin. Invest. 64: 613 1979.
T. A. Davis, I. E. Karl, A. P. Goldberg, and H. R. Harter, Effects of exercise training on muscle protein catabolism in uremia, Kidney Int. in press (1982).
J. O. Holloszy, and F. W. Booth, Biochemical adaptation to endurance exercise in muscle, Annu. Rev. Physiol. 38: 273 1976.
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© 1984 Plenum Press, New York
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Harter, H.R., Davis, T.A., Karl, I.E. (1984). Enhanced Muscle Protein Catabolism in Uremia. In: Hörl, W.H., Heidland, A. (eds) Proteases. Advances in Experimental Medicine and Biology, vol 167. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-9355-3_49
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DOI: https://doi.org/10.1007/978-1-4615-9355-3_49
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