Long-term adaptive responses to dietary protein restriction in chronic renal failure

1995 ◽  
Vol 268 (4) ◽  
pp. E668-E677 ◽  
Author(s):  
K. Tom ◽  
V. R. Young ◽  
T. Chapman ◽  
T. Masud ◽  
L. Akpele ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Dietary Protein ◽  
Protein Turnover ◽  
Whole Body ◽  
Dietary Therapy ◽  
Term Therapy ◽  
Body Protein ◽  
Long Term Therapy

Six patients with chronic renal failure (glomerular filtration rate 18 +/- 2 ml/min) underwent two 10-day admissions separated by at least 1 yr of outpatient therapy with a very low-protein diet (VLPD) providing 0.28 g protein.kg-1.day-1 plus an amino acid-ketoacid supplement. During each Clinical Research Center admission, subjects completed a 5-day nitrogen balance (BN), and whole body protein turnover was measured during fasting and feeding using intravenous [1-13C]leucine and intragastric [5,5,5-2H3]leucine. Outpatient dietary protein compliance was very good (25 vs. 20 g protein/day or 125% goal), whereas energy intake was only 69% of goal (24 vs. 35 kcal.kg-1.day-1). During the 16 +/- 2 mo of dietary therapy, there were no changes in serum proteins or anthropometrics. BN after > or = 1 yr of dietary therapy was neutral and did not differ from initial values (+0.46 +/- 0.20 vs. +0.55 +/- 0.19 g N/day). Similarly, rates of whole body protein synthesis, degradation, and leucine oxidation after long-term therapy with the VLPD regimen did not differ from baseline values, and neutral BN was maintained by a marked suppression of amino acid oxidation and postprandial inhibition of protein degradation. This is the first evidence that the compensatory changes in whole body protein turnover activated in response to dietary protein restriction are sustained during long-term therapy.

scholarly journals Correction of acidosis in hemodialysis decreases whole-body protein degradation.

1997 ◽  
Vol 8 (4) ◽  
pp. 632-637 ◽  
Author(s):  
K A Graham ◽  
D Reaich ◽  
S M Channon ◽  
S Downie ◽  
T H Goodship
Keyword(s):  
Renal Failure ◽  
Protein Degradation ◽  
Protein Turnover ◽  
Whole Body ◽  
Body Protein ◽  
Chronic Metabolic Acidosis ◽  
Optimal Correction ◽  
Kinetics Of ◽  
Amino Acid Concentrations

Correction of acidosis in hemodialysis (HD) decreases protein degradation. The effect of the correction of chronic metabolic acidosis in chronic renal failure patients treated with HD was determined from the kinetics of infused L-[1-(13)C]leucine. Six HD patients were studied before (acid) and after (bicarbonate) correction of acidosis (pH: acid 7.36 +/- 0.01, bicarbonate 7.40 +/- 0.01, P < 0.005). Leucine appearance from body protein (PD) and leucine disappearance into body protein (PS) decreased significantly with correction of acidosis (PD: acid 180.6 +/- 7.3, bicarbonate 130.9 +/- 7.2 mumol.kg-1.h-1, P < 0.005; PS: acid 172.3 +/- 6.8, bicarbonate 122.0 +/- 6.8 mumol.kg-1.h-1, P < 0.005). There was no significant change in leucine oxidation or plasma amino acid concentrations. These results demonstrate that optimal correction of acidosis in HD is beneficial in terms of protein turnover and may improve long-term nutritional status in HD.

scholarly journals Effects of long-term protein excess or deficiency on whole-body protein turnover in sheep nourished by intragastric infusion of nutrients

1995 ◽  
Vol 73 (6) ◽  
pp. 829-839 ◽  
Author(s):  
S. M. Liu ◽  
G. E. Lobley ◽  
N. A. Macleod ◽  
D. J. Kyle ◽  
X.B. Chen ◽  
...  
Keyword(s):  
Dietary Protein ◽  
Protein Turnover ◽  
Protein Intake ◽  
Volatile Fatty Acids ◽  
Whole Body ◽  
N Losses ◽  
Body Protein ◽  
Fractional Rate ◽  
The Difference

The effect of long-term dietary protein excess and deficit on whole-body protein-N turnover (WBPNT) was examined in lambs nourished by intragastric infusions of nutrients. Ten sheep were given 500 mg N/kg metabolic weight (W0.75) per d from casein for 2 weeks and then either 50 (L), 500 (M) or 1500 (H) mg N/kgW0.75per d for 6 weeks. Volatile fatty acids were infused at 500 kJ/kgW0.75per d. Daily WBPNT was measured by continuous intravenous infusion of [l-13C]leucine 3 d before, and on days 2, 21 and 42 after the alteration in protein intake. Whole-body protein-N synthesis (WBPNS) was calculated as the difference between WBPNT and the protein-N losses as urinary NH3and urea. Whole-body protein-N degradation (WBPNS) was then estimated from WBPNS minus protein gain determined from N balance. Fractional rates of WBPNS and WBPND were calculated against fleece-free body N content. WBPNS rates at the L, M and H intakes were respectively 35·1, 41·5 amd 6·37 g/d (P< 0.001) on average over the 6 weeks and WBPND rates were 39·5, 41·1 and 56·8 g/d (P< 0.001). The fractional rates of WBPNS were 5·01, 6·37 and 7·73% per d (P< 0.001) while those of WBPND were 5·64, 6·29 and 6·81% per d (P< 0.005) respectively. On days 2, 21 and 42, WBPNS rates at intake H were 54·0, 61·8 and 75·4 g/d (P= 0·03) respectively, and WBPND rates were 43·2, 56·4 and 70·9 g/d (P= 0.03); at intake L the amounts were 38·2, 34·2 and 32·8 g/d for WBPNS (P= 0.003) and for WBPND were 43·4, 38·0 and 36·9 g/d (P= 0·016) respectively. There were no significant (P> 0·05) differences in fractional rates of WBPNS and WBPND with time at either the L or H intake. We concluded that absolute protein turnover was affected both by dietary protein intake and by body condition while the fractional rate of turnover was predominantly influenced by intake.

Advances in stable isotope tracer methodology part 2: new thoughts about an “old” method—measurement of whole body protein synthesis and breakdown in the fed state

2019 ◽  
Vol 68 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Robert R Wolfe ◽  
Sanghee Park ◽  
Il-Young Kim ◽  
Paul J Moughan ◽  
Arny A Ferrando
Keyword(s):  
Protein Synthesis ◽  
Dietary Protein ◽  
Protein Turnover ◽  
Peripheral Circulation ◽  
Whole Body ◽  
Balance Model ◽  
Body Protein ◽  
Fed State ◽  
Isotope Tracer ◽  
Tracer Dilution

Whole-body protein turnover (protein synthesis, breakdown, and net balance) model enables quantification of the response to a variety of circumstances, including the response to meal feeding. In the fed state, the whole-body protein turnover model requires taking account of the contribution of absorbed tracee to the observed total appearance of tracee in the peripheral blood (exogenous appearance, RaEXO). There are different approaches to estimating RaEXO. The use of an intrinsically labeled dietary protein is based on the overriding assumption that the appearance in the peripheral circulation of a tracer amino acid incorporated into a dietary protein is exactly proportional to the appearance of absorbed tracee. The bioavailability approach is based on the true ileal digestibility of the dietary protein and the irreversible loss of the tracee in the splanchnic bed via hydroxylation of the tracee (phenylalanine). Finally, RaEXO can be estimated as the increase above the basal rate of appearance of the tracee using traditional tracer dilution methodology. In this paper, we discuss the pros and cons of each approach and conclude that the bioavailability method is the least likely to introduce systematic errors and is therefore the preferable approach.

Level of dietary protein impacts whole body protein turnover in trained males at rest

Metabolism ◽  
2006 ◽  
Vol 55 (4) ◽  
pp. 501-507 ◽  
Author(s):  
Patricia C. Gaine ◽  
Matthew A. Pikosky ◽  
William F. Martin ◽  
Douglas R. Bolster ◽  
Carl M. Maresh ◽  
...  
Keyword(s):  
Dietary Protein ◽  
Protein Turnover ◽  
Whole Body ◽  
Body Protein

Rifampin-Associated Thrombocytopenia Secondary to Poor Compliance

DICP ◽  
1989 ◽  
Vol 23 (5) ◽  
pp. 382-384 ◽  
Author(s):  
Pearlie K. Burnette ◽  
Barbara Ameer ◽  
Vu Hoang ◽  
William Phifer
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Platelet Count ◽  
Adverse Reactions ◽  
Term Therapy ◽  
Intermittent Therapy ◽  
Long Term Therapy ◽  
Economic Considerations ◽  
Indigent Patient

Rifampin can be associated with severe adverse effects such as hepatitis, acute renal failure, hemolytic anemia, and thrombocytopenia. Thrombocytopenia has traditionally been associated with intermittent therapy. This article reports the occurrence of rifampin-associated thrombocytopenia in an indigent patient after a four-month lapse in therapy for pulmonary tuberculosis. The patient's platelet count dropped rapidly to a level of 1000/mm3 after receiving a single 600 mg dose of rifampin. After returning to a normal level of > 100 000/mm3, the patient's platelets again dropped to 1200/mm3 with readministration of rifampin. The long-term therapy necessary to eradicate the Mycobacterium tuberculosis organism makes economic considerations important. This patient and other indigent patients who may be poor compliers because they are unable to buy the necessary medication may be at a higher risk for adverse reactions.

Dietary protein requirements and body protein metabolism in endurance-trained men

1989 ◽  
Vol 66 (6) ◽  
pp. 2850-2856 ◽  
Author(s):  
C. N. Meredith ◽  
M. J. Zackin ◽  
W. R. Frontera ◽  
W. J. Evans
Keyword(s):  
Dietary Protein ◽  
Protein Turnover ◽  
Protein Intake ◽  
Whole Body ◽  
Middle Aged ◽  
Body Protein ◽  
Protein Requirements ◽  
High Quality Protein ◽  
Effect Of Age ◽  
Lower Physical Activity

The effects of regular submaximal exercise on dietary protein requirements, whole body protein turnover, and urinary 3-methylhistidine were determined in six young (26.8 +/- 1.2 yr) and six middle-aged (52.0 +/- 1.9 yr) endurance-trained men. They consumed 0.6, 0.9, or 1.2 g.kg-1.day-1 of high-quality protein over three separate 10-day periods, while maintaining training and constant body weight. Nitrogen measurements in diet, urine, and stool and estimated sweat and miscellaneous nitrogen losses showed that they were all in negative nitrogen balance at a protein intake of 0.6 g.kg-1.day-1. The estimated protein requirement was 0.94 +/- 0.05 g.kg-1.day-1 for the 12 men, with no effect of age. Whole body protein turnover, using [15N]glycine as a tracer, and 3-methylhistidine excretion were not different in the two groups, despite lower physical activity of the middle-aged men. Protein intake affected whole body protein flux and synthesis but not 3-methylhistidine excretion. These data show that habitual endurance exercise was associated with dietary protein needs greater than the current Recommended Dietary Allowance of 0.8 g.kg-1.day-1. However, whole body protein turnover and 3-methylhistidine excretion were not different from values reported for sedentary men.

P.48 The effects of pentoxifylline on whole body protein kinetics in chronic renal failure

1997 ◽  
Vol 16 ◽  
pp. 35
Author(s):  
G. Biolo ◽  
G. Toigo ◽  
N. Fiotti ◽  
C. Giansante ◽  
B. Ciocchi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Whole Body ◽  
Protein Kinetics ◽  
Body Protein
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