Hemodialysis-associated protein catabolism with and without glucose in the dialysis fluid.

Abstract

The effects of hemodialysis on protein and energy metabolism were studied in eight hemodialysis patients. The leg exchange of amino acids (AA) was measured during hemodialysis using a dialysis fluid with 10 mmol/liter glucose (GD) or without glucose (GFD). Arterial AA concentrations decreased by about 30% in GD and GFD. During dialysis, similar increases in the efflux of AA from leg tissues (mainly muscle) were observed in GD and GFD (basal 105 +/- 104, vs. 71 +/- 62 nmol/min/100 g tissue; dialysis 295 +/- 46 vs. 289 +/- 60 nmol/min/100 g tissue). The efflux of AA remained largely unchanged at one hour after the end of GD and GFD. Losses of AA to the dialysate were similar during GD (8.3 +/- 0.9 g) and GFD (7.9 +/- 0.4; NS). GFD resulted in a loss of 26 g of glucose whereas 30 of glucose was absorbed during GD. The amount of urea removed by dialysis and the post-dialysis increase in plasma urea were similar in GD and GFD. In conclusion, the addition of glucose to the dialysis fluid may help the energy balance, but it does not appear to reduce the negative effects of hemodialysis on protein metabolism.