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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/14/2810 |
| _version_ | 1797444658474778624 |
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| author | Adrian Post Daan Kremer Dion Groothof Yvonne van der Veen Pim de Blaauw Jennifer van der Krogt Ido P. Kema Ralf Westerhuis M. Rebecca Heiner-Fokkema Stephan J. L. Bakker Casper F. M. Franssen |
| author_facet | Adrian Post Daan Kremer Dion Groothof Yvonne van der Veen Pim de Blaauw Jennifer van der Krogt Ido P. Kema Ralf Westerhuis M. Rebecca Heiner-Fokkema Stephan J. L. Bakker Casper F. M. Franssen |
| author_sort | Adrian Post |
| collection | DOAJ |
| 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 (<i>p</i> = 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 (<i>p</i> < 0.001). Multivariable regression analyses demonstrated that hemodialysis efficacy (Kt/V) was the primary determinant of amino acid losses (Std. β = 0.51; <i>p</i> < 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); <i>p</i> = 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); <i>p</i> = 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); <i>p</i> = 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); <i>p</i> = 0.007). Future studies are warranted to investigate the mechanisms underlying these associations and investigate the potential of taurine supplementation. |
| first_indexed | 2024-03-09T13:14:47Z |
| format | Article |
| id | doaj.art-ab97c9e7fee14edf88dea818cfe988e5 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T13:14:47Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-ab97c9e7fee14edf88dea818cfe988e52023-11-30T21:37:07ZengMDPI AGNutrients2072-66432022-07-011414281010.3390/nu14142810Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis PatientsAdrian Post0Daan Kremer1Dion Groothof2Yvonne van der Veen3Pim de Blaauw4Jennifer van der Krogt5Ido P. Kema6Ralf Westerhuis7M. Rebecca Heiner-Fokkema8Stephan J. L. Bakker9Casper F. M. Franssen10Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDialysis Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsPatients 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 (<i>p</i> = 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 (<i>p</i> < 0.001). Multivariable regression analyses demonstrated that hemodialysis efficacy (Kt/V) was the primary determinant of amino acid losses (Std. β = 0.51; <i>p</i> < 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); <i>p</i> = 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); <i>p</i> = 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); <i>p</i> = 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); <i>p</i> = 0.007). Future studies are warranted to investigate the mechanisms underlying these associations and investigate the potential of taurine supplementation.https://www.mdpi.com/2072-6643/14/14/2810amino acidsplasma concentrationsdialysis losseshemodialysisfatigue |
| spellingShingle | Adrian Post Daan Kremer Dion Groothof Yvonne van der Veen Pim de Blaauw Jennifer van der Krogt Ido P. Kema Ralf Westerhuis M. Rebecca Heiner-Fokkema Stephan J. L. Bakker Casper F. M. Franssen Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients Nutrients amino acids plasma concentrations dialysis losses hemodialysis fatigue |
| 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 | amino acids plasma concentrations dialysis losses hemodialysis fatigue |
| url | https://www.mdpi.com/2072-6643/14/14/2810 |
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