Articles by Veeneman, J. M.
Articles by Huisman, R. M.
Vol. 284, Issue 5, E954-E965, May 2003
Protein intake during hemodialysis maintains a positive whole body protein balance in chronic hemodialysis patients
Jorden M. Veeneman1,2, Hermi A. Kingma3, Theo S. Boer3, Frans Stellaard2,3, Paul E. De Jong1,2, Dirk-Jan Reijngoud2,3, and Roel M. Huisman1,2
Division of Nephrology, Departments of 1 Internal Medicine and 3 Pediatrics, University Hospital Groningen and 2 Groningen University Institute of Drug Exploration, 9713 GZ Groningen, The Netherlands
Protein energy malnutrition is present in 18 to 56% of hemodialysis patients. Because hemodialysis has been regarded as a catabolic event, we studied whether consumption of a protein- and energy-enriched meal improves the whole body protein balance during dialysis in chronic hemodialysis (CHD) patients. Patients were studied on a single day between dialysis (HD protocol) in the morning while fasting and in the afternoon while consuming six small test meals. Patients were also studied during two separate dialysis sessions (HD+ protocol). Patients were fasted during one and consumed the meals during the other. Whole body protein metabolism was studied by primed constant infusion of L-[1-13C]valine. During HD, feeding changed the negative whole body protein balance observed during fasting to a positive protein balance. Dialysis deepened the negative balance during fasting, whereas feeding during dialysis induced a positive balance comparable to the HD protocol while feeding. Plasma valine concentrations during the studies were correlated with whole body protein synthesis and inversely correlated with whole body protein breakdown. We conclude that the consumption of a protein- and energy-enriched meal by CHD patients while dialyzing can strongly improve whole body protein balance, probably because of the increased amino acid concentrations in blood.
protein turnover; stable isotope; valine
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