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Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients
Patients dependent on chronic hemodialysis treatment are prone to malnutrition, at least in part due to insufficient nutrient intake, metabolic derangements, and chronic inflammation. Losses of amino acids during hemodialysis may be an important additional contributor. In this study, we assessed cha...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9318329/ https://www.ncbi.nlm.nih.gov/pubmed/35889768 http://dx.doi.org/10.3390/nu14142810 |
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author | Post, Adrian Kremer, Daan Groothof, Dion van der Veen, Yvonne de Blaauw, Pim van der Krogt, Jennifer Kema, Ido P. Westerhuis, Ralf Heiner-Fokkema, M. Rebecca Bakker, Stephan J. L. Franssen, Casper F. M. |
author_facet | Post, Adrian Kremer, Daan Groothof, Dion van der Veen, Yvonne de Blaauw, Pim van der Krogt, Jennifer Kema, Ido P. Westerhuis, Ralf Heiner-Fokkema, M. Rebecca Bakker, Stephan J. L. Franssen, Casper F. M. |
author_sort | Post, Adrian |
collection | PubMed |
description | Patients dependent on chronic hemodialysis treatment are prone to malnutrition, at least in part due to insufficient nutrient intake, metabolic derangements, and chronic inflammation. Losses of amino acids during hemodialysis may be an important additional contributor. In this study, we assessed changes in plasma amino acid concentrations during hemodialysis, quantified intradialytic amino acid losses, and investigated whether plasma amino acid concentrations and amino acid losses by hemodialysis and urinary excretion are associated with fatigue. The study included a total of 59 hemodialysis patients (65 ± 15 years, 63% male) and 33 healthy kidney donors as controls (54 ± 10 years, 45% male). Total plasma essential amino acid concentration before hemodialysis was lower in hemodialysis patients compared with controls (p = 0.006), while total non-essential amino acid concentration did not differ. Daily amino acid losses were 4.0 ± 1.3 g/24 h for hemodialysis patients and 0.6 ± 0.3 g/24 h for controls. Expressed as proportion of protein intake, daily amino acid losses of hemodialysis patients were 6.7 ± 2.4% of the total protein intake, compared to 0.7 ± 0.3% for controls (p < 0.001). Multivariable regression analyses demonstrated that hemodialysis efficacy (Kt/V) was the primary determinant of amino acid losses (Std. β = 0.51; p < 0.001). In logistic regression analyses, higher plasma proline concentrations were associated with higher odds of severe fatigue (OR (95% CI) per SD increment: 3.0 (1.3; 9.3); p = 0.03), while higher taurine concentrations were associated with lower odds of severe fatigue (OR (95% CI) per log2 increment: 0.3 (0.1; 0.7); p = 0.01). Similarly, higher daily taurine losses were also associated with lower odds of severe fatigue (OR (95% CI) per log2 increment: 0.64 (0.42; 0.93); p = 0.03). Lastly, a higher protein intake was associated with lower odds of severe fatigue (OR (95% CI) per SD increment: 0.2 (0.04; 0.5); p = 0.007). Future studies are warranted to investigate the mechanisms underlying these associations and investigate the potential of taurine supplementation. |
format | Online Article Text |
id | pubmed-9318329 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93183292022-07-27 Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients Post, Adrian Kremer, Daan Groothof, Dion van der Veen, Yvonne de Blaauw, Pim van der Krogt, Jennifer Kema, Ido P. Westerhuis, Ralf Heiner-Fokkema, M. Rebecca Bakker, Stephan J. L. Franssen, Casper F. M. Nutrients Article Patients dependent on chronic hemodialysis treatment are prone to malnutrition, at least in part due to insufficient nutrient intake, metabolic derangements, and chronic inflammation. Losses of amino acids during hemodialysis may be an important additional contributor. In this study, we assessed changes in plasma amino acid concentrations during hemodialysis, quantified intradialytic amino acid losses, and investigated whether plasma amino acid concentrations and amino acid losses by hemodialysis and urinary excretion are associated with fatigue. The study included a total of 59 hemodialysis patients (65 ± 15 years, 63% male) and 33 healthy kidney donors as controls (54 ± 10 years, 45% male). Total plasma essential amino acid concentration before hemodialysis was lower in hemodialysis patients compared with controls (p = 0.006), while total non-essential amino acid concentration did not differ. Daily amino acid losses were 4.0 ± 1.3 g/24 h for hemodialysis patients and 0.6 ± 0.3 g/24 h for controls. Expressed as proportion of protein intake, daily amino acid losses of hemodialysis patients were 6.7 ± 2.4% of the total protein intake, compared to 0.7 ± 0.3% for controls (p < 0.001). Multivariable regression analyses demonstrated that hemodialysis efficacy (Kt/V) was the primary determinant of amino acid losses (Std. β = 0.51; p < 0.001). In logistic regression analyses, higher plasma proline concentrations were associated with higher odds of severe fatigue (OR (95% CI) per SD increment: 3.0 (1.3; 9.3); p = 0.03), while higher taurine concentrations were associated with lower odds of severe fatigue (OR (95% CI) per log2 increment: 0.3 (0.1; 0.7); p = 0.01). Similarly, higher daily taurine losses were also associated with lower odds of severe fatigue (OR (95% CI) per log2 increment: 0.64 (0.42; 0.93); p = 0.03). Lastly, a higher protein intake was associated with lower odds of severe fatigue (OR (95% CI) per SD increment: 0.2 (0.04; 0.5); p = 0.007). Future studies are warranted to investigate the mechanisms underlying these associations and investigate the potential of taurine supplementation. MDPI 2022-07-08 /pmc/articles/PMC9318329/ /pubmed/35889768 http://dx.doi.org/10.3390/nu14142810 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Post, Adrian Kremer, Daan Groothof, Dion van der Veen, Yvonne de Blaauw, Pim van der Krogt, Jennifer Kema, Ido P. Westerhuis, Ralf Heiner-Fokkema, M. Rebecca Bakker, Stephan J. L. Franssen, Casper F. M. Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients |
title | Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients |
title_full | Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients |
title_fullStr | Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients |
title_full_unstemmed | Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients |
title_short | Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients |
title_sort | amino acid homeostasis and fatigue in chronic hemodialysis patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9318329/ https://www.ncbi.nlm.nih.gov/pubmed/35889768 http://dx.doi.org/10.3390/nu14142810 |
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