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Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients
INTRODUCTION: Skeletal muscle loss is common in patients with renal failure who receive maintenance hemodialysis (MHD) therapy. Regular ingestion of protein-rich meals are recommended to help offset muscle protein loss in MHD patients, but little is known about the anabolic potential of this strateg...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224635/ https://www.ncbi.nlm.nih.gov/pubmed/30450467 http://dx.doi.org/10.1016/j.ekir.2018.08.001 |
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author | van Vliet, Stephan Skinner, Sarah K. Beals, Joseph W. Pagni, Brandon A. Fang, Hsin-Yu Ulanov, Alexander V. Li, Zhong Paluska, Scott A. Mazzulla, Michael West, Daniel W.D. Moore, Daniel R. Wilund, Kenneth R. Burd, Nicholas A. |
author_facet | van Vliet, Stephan Skinner, Sarah K. Beals, Joseph W. Pagni, Brandon A. Fang, Hsin-Yu Ulanov, Alexander V. Li, Zhong Paluska, Scott A. Mazzulla, Michael West, Daniel W.D. Moore, Daniel R. Wilund, Kenneth R. Burd, Nicholas A. |
author_sort | van Vliet, Stephan |
collection | PubMed |
description | INTRODUCTION: Skeletal muscle loss is common in patients with renal failure who receive maintenance hemodialysis (MHD) therapy. Regular ingestion of protein-rich meals are recommended to help offset muscle protein loss in MHD patients, but little is known about the anabolic potential of this strategy. METHODS: Eight MHD patients (age: 56 ± 5 years; body mass index [BMI]: 32 ± 2 kg/m(2)) and 8 nonuremic control subjects (age: 50 ± 2 years: BMI: 31 ± 1 kg/m(2)) received primed continuous L-[ring-(2)H(5)]phenylalanine and L-[1-(13)C]leucine infusions with blood and muscle biopsy sampling on a nondialysis day. Participants consumed a mixed meal (546 kcal; 20-g protein, 59-g carbohydrates, 26-g fat) with protein provided as L-[5,5,5-(2)H(3)]leucine-labeled eggs. RESULTS: Circulating dietary amino acid availability was reduced in MHD patients (41 ± 5%) versus control subjects (61 ± 4%; P = 0.03). Basal muscle caspase-3 protein content was elevated (P = 0.03) and large neutral amino acid transporter 1 (LAT1) protein content was reduced (P = 0.02) in MHD patients versus control subjects. Basal muscle protein synthesis (MPS) was ∼2-fold higher in MHD patients (0.030 ± 0.005%/h) versus control subjects (0.014 ± 0.003%/h) (P = 0.01). Meal ingestion failed to increase MPS in MHD patients (absolute change from basal: 0.0003 ± 0.007%/h), but stimulated MPS in control subjects (0.009 ± 0.002%/h; P = 0.004). CONCLUSIONS: MHD patients demonstrated muscle anabolic resistance to meal ingestion. This blunted postprandial MPS response in MHD patients might be related to high basal MPS, which results in a stimulatory ceiling effect and/or reduced plasma dietary amino acid availability after mixed-meal ingestion. |
format | Online Article Text |
id | pubmed-6224635 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-62246352018-11-16 Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients van Vliet, Stephan Skinner, Sarah K. Beals, Joseph W. Pagni, Brandon A. Fang, Hsin-Yu Ulanov, Alexander V. Li, Zhong Paluska, Scott A. Mazzulla, Michael West, Daniel W.D. Moore, Daniel R. Wilund, Kenneth R. Burd, Nicholas A. Kidney Int Rep Clinical Research INTRODUCTION: Skeletal muscle loss is common in patients with renal failure who receive maintenance hemodialysis (MHD) therapy. Regular ingestion of protein-rich meals are recommended to help offset muscle protein loss in MHD patients, but little is known about the anabolic potential of this strategy. METHODS: Eight MHD patients (age: 56 ± 5 years; body mass index [BMI]: 32 ± 2 kg/m(2)) and 8 nonuremic control subjects (age: 50 ± 2 years: BMI: 31 ± 1 kg/m(2)) received primed continuous L-[ring-(2)H(5)]phenylalanine and L-[1-(13)C]leucine infusions with blood and muscle biopsy sampling on a nondialysis day. Participants consumed a mixed meal (546 kcal; 20-g protein, 59-g carbohydrates, 26-g fat) with protein provided as L-[5,5,5-(2)H(3)]leucine-labeled eggs. RESULTS: Circulating dietary amino acid availability was reduced in MHD patients (41 ± 5%) versus control subjects (61 ± 4%; P = 0.03). Basal muscle caspase-3 protein content was elevated (P = 0.03) and large neutral amino acid transporter 1 (LAT1) protein content was reduced (P = 0.02) in MHD patients versus control subjects. Basal muscle protein synthesis (MPS) was ∼2-fold higher in MHD patients (0.030 ± 0.005%/h) versus control subjects (0.014 ± 0.003%/h) (P = 0.01). Meal ingestion failed to increase MPS in MHD patients (absolute change from basal: 0.0003 ± 0.007%/h), but stimulated MPS in control subjects (0.009 ± 0.002%/h; P = 0.004). CONCLUSIONS: MHD patients demonstrated muscle anabolic resistance to meal ingestion. This blunted postprandial MPS response in MHD patients might be related to high basal MPS, which results in a stimulatory ceiling effect and/or reduced plasma dietary amino acid availability after mixed-meal ingestion. Elsevier 2018-08-17 /pmc/articles/PMC6224635/ /pubmed/30450467 http://dx.doi.org/10.1016/j.ekir.2018.08.001 Text en © 2018 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Research van Vliet, Stephan Skinner, Sarah K. Beals, Joseph W. Pagni, Brandon A. Fang, Hsin-Yu Ulanov, Alexander V. Li, Zhong Paluska, Scott A. Mazzulla, Michael West, Daniel W.D. Moore, Daniel R. Wilund, Kenneth R. Burd, Nicholas A. Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients |
title | Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients |
title_full | Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients |
title_fullStr | Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients |
title_full_unstemmed | Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients |
title_short | Dysregulated Handling of Dietary Protein and Muscle Protein Synthesis After Mixed-Meal Ingestion in Maintenance Hemodialysis Patients |
title_sort | dysregulated handling of dietary protein and muscle protein synthesis after mixed-meal ingestion in maintenance hemodialysis patients |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224635/ https://www.ncbi.nlm.nih.gov/pubmed/30450467 http://dx.doi.org/10.1016/j.ekir.2018.08.001 |
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