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Experience with prolonged intradialysis hyperalimentation in catabolic chronic dialysis patients

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Abstract

Protein and caloric deficits can develop easily during chronic dialysis-therapy (CDT)1–7. Amino acid loss from plasma to dialysate and accidental blood loss during haemodialysis occur4,8,9. Altered taste sense10–11 and suppressed appetite result in inadequate food intake which is not improved easily in our experience, by dietary advice. Intercurrent stressful events, such as infection, gastrointestinal bleeding, cardiac arrythmia, etc., cause increased protein catabolic rates12–13. Such periods of weight loss frequently result in a failure to return to the original weight.

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References

  1. Schaeffer, G., Heinze, V., Jontofosohn, R., Katz, N., Rippich, T. H., Schafer, B., Sudoff, A., Zimmerman, W. and Kluthe, R. (1975). Amino acid and protein intake in RDT patients: a nutritional and biochemical analysis. Clin. Nephrol., 3, 228

    CAS  Google Scholar 

  2. Bianchi, R., Mariani, G., Giuseppina, T. M. and Carmassi, F. (1978). The metabolism of human serum albumin in renal failure on conservative and dialysis therapy. Am. J. Clin. Nutr., 31, 1615

    CAS  Google Scholar 

  3. Farrell, P. C. and Hone, P. W. (1980). Dialysis-induced catabolism. Am. J. Clin. Nutr., 33, 1417

    CAS  Google Scholar 

  4. Tepper, J., Vanderhem, B. K., Tuma, G. J., Arisz, L. and Donker, A. J. M. (1978). Loss of amino acids during hemodialysis: quantitative and qualitative investigations. Clin. Nephrol., 10, 16

    CAS  Google Scholar 

  5. Young, G. A. and Parsons, F. M. (1970). Plasma amino acid imbalance in patients with chronic renal failure on intermittent dialysis. Clin. Chim. Acta, 27, 491

    Article  CAS  Google Scholar 

  6. Maillet, C. and Garber, A. J. (1980). Skeletal muscle amino acid metabolism in chronic uremia. Am. J. Clin. Nutr., 33, 1343

    CAS  Google Scholar 

  7. Kopple, J. D. and Swendseid, M. E. (1975). Protein and amino acid metabolism in uremic patients undergoing maintenance dialysis. Kidney Int., 7 (Suppl.), 64

    Google Scholar 

  8. Rubini, M. E. and Gordon, S. (1968). Individual plasma-free amino acids in uremics: effect of hemodialysis. Nephron, 5, 339

    Article  CAS  Google Scholar 

  9. Kopple, J. D., Swendseid, M. E., Shinaberger, J. H. and Umezana, C. Y. (1973). The free and bound amino acids removed by hemodialysis. Trans. Am. Soc. Artif. Organs, 19, 309

    Article  CAS  Google Scholar 

  10. Burge, J. C., Park, H. S., Witlock, C. P. and Schemmel, R. A. (1979). Taste acuity in patients undergoing long-term hemodialysis. Kidney Int., 15, 49

    Article  CAS  Google Scholar 

  11. Mahajan, S. K., Prasad, A. S., Lambujon, J., Abassi, A. A., Briggs, W. A. and McDonald, F. D. (1980). Improvement of uremia hypogeusia by zinc: a double blind study. Am. J. Clin. Nutr., 33, 1517

    CAS  Google Scholar 

  12. Grodstein, G. P., Blumenkrantz, M. J. and Kopple, J. D. (1980). Nutritional and metabolic response to catabolic stress in uremia. Am. J. Clin. Nutr., 33, 1411

    CAS  Google Scholar 

  13. Giordano, C., DeSanto, N. G. and Senatore, R. (1978). Effects of catabolic stress in acute and chronic renal failure. Am. J. Clin. Nutr., 31, 1561

    CAS  Google Scholar 

  14. Piraino, A. J., Firpo, J. J. and Powers, D. V. (1981). Prolonged hyperalimentation in catabolic chronic dialysis therapy patients. J. Parenteral Enteral Nutr., 5, 463

    Article  CAS  Google Scholar 

  15. Fürst, P., Bergstrom, J., Josephson, B. and Noree, L-O. (1970). The effect of dialysis and administration of essential amino acids on plasma and muscle synthesis. Studies with 15N in uraemic patients. Proc. Eur. Dial. Transplant. Assoc., 7, 175

    Google Scholar 

  16. DeFronzo, R. A. and Alvestrand, A. (1980). Glucose intolerance in uremia: site and mechanism. Am. J. Clin. Nutr., 33, 1438

    CAS  Google Scholar 

  17. Metcoff, J., Lindeman, R., Baxter, D. and Pederson, J. (1978). Cell metabolism in uremia. Am. J. Clin. Nutr., 30, 1627

    Google Scholar 

  18. Giordano, C., Depascale, C., Pluvio, M., DeSanto, N. G., Fella, A., Esposito, R., Capasso, G. and Pota, A. (1975). Adverse effects among amino acids in uremia. Kidney Int., 7 (Suppl.), 306

    Google Scholar 

  19. Harper, A. E., Benevange, N. J. and Wohlhueter, R. M. (1970). Effects of ingestion of disproportionate amounts of amino acids. Physiol. Rev., 50, 428

    CAS  Google Scholar 

  20. Wolfson, M., Jones, M. R. and Kopple, J. D. (1982). Amino acid losses during dialysis with infusion of amino acids and glucose. Kidney Int., 21, 500

    Article  CAS  Google Scholar 

  21. Avram, M. M., Iancu, M., Morrow, P., Feinfeld, D. and Huatuco, A. (1979). Uremic syndrome in man: new evidence for parathormone as a multisystem neurotoxin. Clin. Nephrol., 11, 59

    CAS  Google Scholar 

  22. Mallete, L. E., Patten, B. M. and Engel, W. K. (1975). Neuromuscular disease in secondary hyperparathyroidism. Ann. Intern. Med., 82, 474

    Google Scholar 

  23. Garber, A. J. (1976). Abnormalities of carbohydrate metabolism in chronic uremia. In B. B. Mackey (ed.). Proceedings of the 9th Annual Contractors Conference of the Artificial/ Chronic Uremia Program, National Institute of Arthritis, Metabolism and Digestive Diseases. pp. 5–8. ( Bethesda, Maryland: US Department of Health, Education and Welfare, National Institutes of Health )

    Google Scholar 

  24. Rose, W. C. (1931). Feeding experiments with mixtures of highly purified amino acids. I. The inadequacy of diets containing 19 amino acids. J. Biol. Chem., 94, 155

    CAS  Google Scholar 

  25. Rogers, Q. R. and Leung, M. G. (1977). The control of food intake: when and how are amino acids involved. In M. Kare and O. Mailer (eds.). The Chemical Senses and Nutrition. pp. 213–249. (New York: Academic Press )

    Google Scholar 

  26. Peng, Y., Tews, J. K. and Harper, A. E. (1972). Amino acid imbalance, protein intake and changes in rat brain and plasma amino acids. Am. J. Physiol., 222, 314

    CAS  Google Scholar 

  27. Bergstrom, J., Fürst, P., Noree, L-O. and Vinnars, E. (1978). Amino acids in muscle tissue of patients with chronic uraemia: effect of peritoneal dialysis and infusion of essential amino acids. Clin. Sci. Mol. Med., 54, 51

    CAS  Google Scholar 

  28. Swendseid, M. E., Wang, M., Vyhmeister, I., Chan, W., Siassi, F., Tam, C. F. and Kopple, J. D. (1976). Amino acid metabolism in the chronically uremic rat. Clin. Nephrol., 3, 240

    Google Scholar 

  29. Fürst, P. (1972). 15N studies in severe renal failure. II. Evidence for the essentiality of histidine. Scand. J. Clin. Lab. Invest., 30, 307

    Google Scholar 

  30. Swendseid, M. E. and Kopple, J. D. (1975). Evidence that histidine is an essential amino acid in normal and chronically uremic man. J. Clin. Invest., 55, 881

    Article  Google Scholar 

  31. Bergstrom, J., Fürst, P., Noree, L-O. and Vinnars, E. (1975). Intracellular free amino acids in uremic patients as influenced by amino acid supply. Kidney Int., 7, 345

    Google Scholar 

  32. Pitts, R. F., Damian, A. C. and MacLeod, M. G. (1970). Synthesis of serine by rat kidney in vivo and in vitro. Am. J. Physiol., 219, 584

    CAS  Google Scholar 

  33. Fukuda, S. and Kopple, J. D. (1980). Uptake and release of amino acids by the kidney of dogs made chronically uremic with uranyl nitrate. Min. Electrolyte Metabol., 3, 248

    CAS  Google Scholar 

  34. Giordano, C. (1972). Diet in uremia. Proceedings of the European Dialysis and Transplant Association, 9, 419

    CAS  Google Scholar 

  35. Fürst, P., Alvestrand, A. and Bergstrom, J. (1980). Effects of nutrition and catabolic stress on intracellular amino acid pools in uremia. Am. J. Clin. Nutr., 33, 1387

    Google Scholar 

  36. McGale, E. H. F., Pickford, J. C. and Aber, G. M. (1972). Quantitative changes in plasma amino acids in patients with renal disease. Clin. Chim. Acta, 38, 395

    Article  CAS  Google Scholar 

  37. Counahan, R., El-Bishti, M., Cox, B. D., Ogg, C. S. and Chantler (1976). Plasma amino acids in children and adolescents on hemodialysis. Kidney Int., 10, 471

    Article  CAS  Google Scholar 

  38. Alvestrand, A., Bergstrom, J., Fürst, P., Germanis, G. and Widstam, U. (1978). The effect of essential amino acid supplementation on muscle and plasma free amino acids in chronic uremia. Kidney Int., 14, 323

    Article  CAS  Google Scholar 

  39. Alvestrand, A., Ahlberg, M., Bergstrom, J. and Fürst, P. (1981). Effects of nutritional regimens on branched chain amino acid (BCAA) antagonism in uremia. In M. Waisen and J. Williamson (eds.). Metabolism and Clinical Implications of Branched-Chain Amino and Keto Acids. pp. 605–613. (New York: Elsevier/North Holland )

    Google Scholar 

  40. Alvestrand, A., Bergstrom, J. and Fürst, P. (1979). Intracellular free amino acids in patients treated with regular haemodialysis. Proc. EDTA, 16, 129

    CAS  Google Scholar 

  41. Chami, J., Reidenberg, M. M., Wellner, D., David, D. S., Rubin, A. L. and Stenzel, K. H. (1978). Pharmacokinetics of essential amino acids in chronic dialysis patients. Am. J. Clin. Nutr., 31, 1652

    CAS  Google Scholar 

  42. Roscoe, J. P., Eaton, M. D. and Choy, G. C. (1968). Inhibition of protein synthesis in Krebs 2 ascites cells and cell-free systems by phenylalanine and its effect on leucine and lysine in the amino acid pool. Biochem. J., 109, 507

    CAS  Google Scholar 

  43. Klavins, J. V. (1965). Pathology of amino acid excess. V. effects of methionine on free amino acids in serum. Biochim. Biophys. Acta, 104, 554

    Article  CAS  Google Scholar 

  44. Freund, H. R., Ryan, J. A. and Fischer, J. E. (1978). Amino acid dearrangements in patients with sepsis: treatment with branched chain amino acids rich infusion. Am. Surg., 188, 423

    CAS  Google Scholar 

  45. Menyhart, J. and Grof, J. (1977). Urea as a selective inhibitor of arginosuccinate lyase. Eur. J. Biochem., 75, 405

    Article  CAS  Google Scholar 

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© 1983 MTP Press Limited

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Powers, D.V., Piraino, A.J. (1983). Experience with prolonged intradialysis hyperalimentation in catabolic chronic dialysis patients. In: Johnston, I.D.A. (eds) Advances in Clinical Nutrition. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5918-0_11

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  • DOI: https://doi.org/10.1007/978-94-011-5918-0_11

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-5920-3

  • Online ISBN: 978-94-011-5918-0

  • eBook Packages: Springer Book Archive

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